Liu, J. Y.; Hu, J.; Zhang, Qiang; ...
Weyl (WSMs) evolve from Dirac semimetals in the presence of broken time-reversal symmetry (TRS) or space-inversion symmetry. The WSM phases in TaAs-class materials and photonic crystals are due to the loss of space-inversion symmetry. For TRS-breaking WSMs, despite numerous theoretical and experimental efforts, few examples have been reported. Here in this paper, we report a new type of magnetic semimetal Sr 1-yMn 1-zSb 2 (y, z < 0.1) with nearly massless relativistic fermion behaviour (m* = 0.04 - 0.05m 0, where m 0 is the free-electron mass). This material exhibits a ferromagnetic order for 304 K < T < 565more » K, but a canted antiferromagnetic order with a ferromagnetic component for T < 304 K. The combination of relativistic fermion behaviour and ferromagnetism in Sr 1-yMn 1-zSb2 offers a rare opportunity to investigate the interplay between relativistic fermions and spontaneous TRS breaking.« less
Liu, J. Y.; Hu, J.; Zhang, Qiang
Weyl (WSMs) evolve from Dirac semimetals in the presence of broken time-reversal symmetry (TRS) or space-inversion symmetry. The WSM phases in TaAs-class materials and photonic crystals are due to the loss of space-inversion symmetry. For TRS-breaking WSMs, despite numerous theoretical and experimental efforts, few examples have been reported. Here in this paper, we report a new type of magnetic semimetal Sr 1-yMn 1-zSb 2 (y, z < 0.1) with nearly massless relativistic fermion behaviour (m* = 0.04 - 0.05m 0, where m 0 is the free-electron mass). This material exhibits a ferromagnetic order for 304 K < T < 565more » K, but a canted antiferromagnetic order with a ferromagnetic component for T < 304 K. The combination of relativistic fermion behaviour and ferromagnetism in Sr 1-yMn 1-zSb2 offers a rare opportunity to investigate the interplay between relativistic fermions and spontaneous TRS breaking.« less
Vasin, Sandra; Carle, Achim; Lang, Ulrich; Kirchholtes, Hermann Josef
In general, groundwater in urban areas is exposed to anthropogenic influence and suffers from concentrations of contaminants. Stuttgart, as a highly industrialized city, has more than 5000 contaminated sites which might influence the Stuttgart's mineral water quality. Despite tremendous efforts and intensive single site orientated remediation since 1984 in downtown, the mineral springs were still affected with chlorinated hydrocarbons at low concentrations. Therefore, the applied practices of environmental management and measures for mitigation of pollution sources were not sufficient and had to be adjusted. The main goal of this study is to define an integral remediation plan (a groundwater management plan), focusing on the key sources of chlorinated solvents which are relevant for the mineral springs. For the large-scale investigated area of 26.6km(2) and eight aquifers, an extensive investigation and characterization methods were used in order to delineate the contamination plumes. By means of a 3D numerical model, the prioritization of the contaminated sites could be performed. Five contaminated sites with high remediation priority and need for optimized or additional remediation efforts were determined. For those five contaminated sites feasibility studies were performed which resulted in recommendation of remediation measures with total costs of more than 12.5 million euros. The proposed strategy and approach are suitable for multiple sources of contamination. Only in this way, the contributions of single contaminated sites to the total groundwater contamination can be identified and local remediation measures with their spatial impact simulated. Due to very complex geological conditions, technically there is no alternative to this strategy in order to achieve the contamination reduction in groundwater. Copyright © 2015 Elsevier B.V. All rights reserved.
The paper deals with the aspects of professional training of specialists in computational linguistics by the example of the University of Stuttgart. First of all, we have attempted to define the essence of the terms "applied linguistics" and "computational linguistics" based on the views of Ukrainian and foreign scholars. We…
Hill, Christine; Bretschneider, Jens; Nathanson, Emil; Grossmann, Agnes
Yuri’s Night - also known as the “World Space Party” - is the annual celebration commemorating Gagarin’s historic flight on April 12, 1961, and the maiden voyage of the American space shuttle on April 12, 1981. It was created by young space enthusiasts in 2000 at the annual Space Generation Congress and was first celebrated in 2001, registering more than 60 events around the world from the start. Since then the interest in celebrating human spaceflight grew constantly to over 350 events across all seven continents in 2013. The honoring of Yuri Gagarin’s first spaceflight in Stuttgart started in 2007 and resulted in one of the largest events outside the US, with five parties following in 2008, 2009, 2010, 2012 and 2013. The Stuttgart event was originally organized as space party for an audience at the age of 20 and beyond including informative aspects at the afternoon and a following party far into the night. Since 2010 the focus of the Yuri’s Night Stuttgart is to bring awareness of space exploration to people of all ages, including particularly many participatory hands-on space activities for kids and families that attract hundreds of visitors every year. As much as Yuri’s Night is a worldwide party, the events in Stuttgart successfully concentrate on educational aspects that help to inspire new generations of space enthusiasts who will ultimately shape the future of space exploration. It is therefore not only a look back to one of the greatest achievements of the 20th Century, but it is also a look into the future: from multinational cooperation on the International Space Station to benefit of space flight to the introduction of the next generation of space technology. This paper will introduce the celebrations of Yuri’s Night in Stuttgart of the past four years and compare them to the early events. It provides a summary of the development of the Yuri’s Night including educational aspects, public relations and media attraction and gives
4rREVISED UNIFORM SUMMARY OF SURFACE WEATHER OBSERVATIONS STUTTGART GERMANY MSC # 107380 N 48 41 K 009 13 ELEV 1300 FT EDOC PARTS A - F HOURS SUMMARIZED 0000...1 .. L. b I.E 725O0 14.2 24.A 26.4 32.3 32.1 33.6 34.2 36.7 37.7 9.2 39.c 39.5 39.7 .e 40. 1 I. . GE 6’ UC 1 14.4 25.3 27.0 30.6 32.8 34. 2 34*. 37.4...28.9 30.1 33.8 35.8 36.7 37.3 39.1 39.6 40.0 40.2 60.5 60.6 60.7 41.1 1.9 6E 8- uC l7.9 3L. b 31 .9 35.838 V.. 39. 139 . 7- 6’.6 - 42. 1-62. 7 42.9 4
Wink, Rüdiger; Kirchner, Laura; Koch, Florian; Speda, Daniel
This paper links two strands of literature (collective learning and resilience) by looking at experiences with collective learning as precondition of regional economic resilience. Based on a qualitative empirical study, the emergence of collective learning structures in the Stuttgart region after a macroeconomic and structural crisis at the…
Ketterer, Christine; Matzarakis, Andreas
This study of the urban heat island (UHI) aims to support planning authorities by going beyond the traditional way of urban heat island studies. Therefore, air temperature as well as the physiologically equivalent temperature (PET) were applied to take into account the effect of the thermal atmosphere on city dwellers. The analysis of the urban heat island phenomenon of Stuttgart, Germany, includes a long-term frequency analysis using data of four urban and one rural meteorological stations. A (high resolution map) of the UHI intensity and PET was created using stepwise multiple linear regression based on data of car traverses as well as spatial data. The mapped conditions were classified according to the long-term frequency analysis. Regarding climate change, the need for adaptation measures as urban greening is obvious. Therefore, a spatial analysis of quantification of two scenarios of a chosen study area was done by the application of a micro-scale model. The nocturnal UHI of Stuttgart is during 15 % stronger than 4 K in the city center during summer when daytime heat stress occurs during 40 %. A typical summer condition is mapped using statistical approach to point out the most strained areas in Stuttgart center and west. According to the model results, the increase in number of trees in a chosen area (Olga hospital) can decrease PET by 0.5 K at 22:00 CET but by maximum 27 K at 14:00 CET.
The University of Stuttgart's Institut fuer Kernenergetik und Energiesysteme (IKE) and the University of Arizona have had a joint program in which graduate students from the IKE spend 1 yr on the University of Arizona campus. This program started in 1982 largely as the result of an initiative begun by K.H. Hoecker, then director of IKE. Since 1985, Alfred Voss has been director and the program has continued without interruption. Under the program, the Deutscher Akademisher Austauschdienst, a government agency of the Federal Republic of Germany has funded scholarships for students from IKE, which provide support for 1 yr duringmore » which they attend the University of Arizona as visiting student scholars and engage in a research project under the direction of one of our faculty, which satisfies a part of the requirements for the Ingenieur-Diplom Fachrichtung Maschinenbau. The students get credit for their research from the University of Stuttgart. The topics have a broad range and include software development, artificial intelligence, radiation transport, and energy management studies.« less
Germany's national (or ethnic) identity has become thoroughly European and there are even signs of Eurocentrism. This is particularly problematic for the Turkish Muslims who, arguably, are not European. This article explores how fifteen-year-old German and Turkish youth in two Stuttgart secondary schools, one in a predominantly working-class area…
Reyer, Maren; Fina, Stefan; Siedentop, Stefan; Schlicht, Wolfgang
In modern Western societies people often lead inactive and sedentary lifestyles, even though there is no doubt that physical activity and health are related. From an urban planning point of view it would be highly desirable to develop built environments in a way that supports people in leading more active and healthy lifestyles. Within this context there are several methods, predominantly used in the US, to measure the suitability of built environments for walking and cycling. Empirical studies show that people living in highly walkable areas are more physically active (for example, walk more or cycle more). The question is, however, whether these results are also valid for European cities given their different urban planning characteristics and infrastructure standards. To answer this question we used the Walkability-Index and the Walk Score to empirically investigate the associations between walkability and active transportation in the city of Stuttgart, Germany. In a sample of household survey data (n = 1.871) we found a noticeable relationship between walkability and active transportation-the more walkable an area was, the more active residents were. Although the statistical effect is small, the health impact might be of relevance. Being physically active is multi-determined and not only affected by the walkability of an area. We highlight these points with an excursion into research that the health and exercise sciences contribute to the topic. We propose to strengthen interdisciplinary research between the disciplines and to specifically collect data that captures the influence of the environment on physical activity in the future.
Reyer, Maren; Fina, Stefan; Siedentop, Stefan; Schlicht, Wolfgang
In modern Western societies people often lead inactive and sedentary lifestyles, even though there is no doubt that physical activity and health are related. From an urban planning point of view it would be highly desirable to develop built environments in a way that supports people in leading more active and healthy lifestyles. Within this context there are several methods, predominantly used in the US, to measure the suitability of built environments for walking and cycling. Empirical studies show that people living in highly walkable areas are more physically active (for example, walk more or cycle more). The question is, however, whether these results are also valid for European cities given their different urban planning characteristics and infrastructure standards. To answer this question we used the Walkability-Index and the Walk Score to empirically investigate the associations between walkability and active transportation in the city of Stuttgart, Germany. In a sample of household survey data (n = 1.871) we found a noticeable relationship between walkability and active transportation—the more walkable an area was, the more active residents were. Although the statistical effect is small, the health impact might be of relevance. Being physically active is multi-determined and not only affected by the walkability of an area. We highlight these points with an excursion into research that the health and exercise sciences contribute to the topic. We propose to strengthen interdisciplinary research between the disciplines and to specifically collect data that captures the influence of the environment on physical activity in the future. PMID:24886755
Zastrow, Armin; Wittwer, Volker
Efficient daylighting systems have recently attracted increasing interest due to their potential for saving a condiderable amount of electrical energy used for lighting purposes. In this paper we discuss the properties of daylighting systems based on either fluorescent planar concentrators (FPC's) and transparent light guiding plates or light pipes coated with a highly reflective silver coated plastic film (3M Silverlux film). First results on daylighting systems in the students' living quarters in Stuttgart-Hohenheim will be presented. This is a demonstration project which is supported by the Commission of the European Communities.
Franz, M.; Nowak, K.; Berner, U.; Heunisch, C.; Bandel, K.; Röhling, H.-G.; Wolfgramm, M.
The deposition of the Stuttgart Formation ('Schilfsandstein'), commonly considered as a type-example of the Carnian Pluvial Event, was controlled by high frequent 4th order sequences that resulted in pre-, intra- and post-Schilfsandstein transgressions from Tethyan waters into the epicontinental Central European Basin (CEB). The pre-Schilfsandstein transgression flooded the CEB trough gates to the Southeast and resulted in a wide-spread inland sea that was characterised by increased biological productivity, predominantly oxic conditions and enabled the immigration of euryhaline marine fauna with plankton, ostracodes, fishes, bivalves and the gastropods Omphaloptychia suebica n. sp. and Settsassia stuttgartica n. sp. The rather short-term intra- and post-Schilfsandstein transgressions flooded the CEB from the Southwest and Southeast and established a shallow brackish inland sea that stretched up to North Germany. Both, the 4th and 3rd order sequences derived from the succession in the CEB correlate well with those derived from successions of Tethyan shelfs. Therefore pronounced circum-Tethyan eustatic cycles are evidenced and may have had considerable impact on prominent middle Carnian events: Reingraben turnover, Carnian Pluvial Event, Carnian Crisis and Mid Carnian Wet Intermezzo. The broad circum-Tethyan evidence of 106-year scale cycles suggests glacioeustatic sea-level changes even in the Triassic Greenhouse period.
Fallmann, Joachim; Suppan, Peter; Emeis, Stefan
Cities are warmer than their surroundings (called urban heat island, UHI). UHI influence urban atmospheric circulation, air quality, and ecological conditions. UHI leads to upward motion and compensating near-surface inflow from the surroundings which import rural trace substances. Chemical and aerosol formation processes are modified due to increased temperature, reduced humidity and modified urban-rural trace substance mixtures. UHIs produce enhanced heat stress for humans, animals and plants, less water availability and modified air quality. Growing cities and Climate Change will aggravate the UHI and its effects and urgently require adaptation and mitigation strategies. Prior to this, UHI properties must be assessed by surface observations, ground- and satellite-based vertical remote sensing and numerical modelling. The Weather Research and Forecasting Model (WRF) is an instrument to simulate and assess this phenomenon based on boundary conditions from observations and global climate models. Three urbanization schemes are available with WRF, which are tested during this study for different weather conditions in central Europe and will be enhanced if necessary. High resolution land use maps are used for this modeling effort. In situ measurements and Landsat thermal images are employed for validation of the results. The study will focus on the city of Stuttgart located in the south western part of Germany that is situated in a caldera-like orographic feature. This municipality has a long tradition in urban climate research and thus is well equipped with climatologic measurement stations. By using Geographical Information Systems (GIS), it is possible to simulate several scenarios for different surface properties. By increasing the albedo of roof and wall layers in the urban canopy model or by replacing urban land use by natural vegetation, simple urban planning strategies can be tested and the effect on urban heat island formation and air quality can be
The history of Jewish nursing in World War I has so far not been central to medical history research. Rosa Bendit's war diary is still the only source available on the voluntary service Jewish nurses provided during World War I. Their number was small compared to that of nurses in general. Jewish nursing in Germany has hardly been researched. Jewish nurses, like their Christian colleagues, took on wartime nursing tasks voluntarily. This paper will focus on the experiences of the nurses who were sent to various locations in East and West by the Stuttgart Jewish Nurses' Home. Based on quotations from the war diary their position within the medical service will be described, compared and analyzed. The paper draws attention to special characteristics in the comparison ofJewish and Christian nurses and explores issues such as religious observance, religious discrimination, patriotism and differences in the evaluation of the nurses' work. A brief outline of the history of the Stuttgart Jewish Nurses' Home illustrates their working conditions. The Jewish nurses applied themselves with as much effort and devotion as their Christian counterparts. Although there were only few of them, the Jewish nurses managed to establish a recognized position for themselves within the medical service. The history of Jewish nursing in Stuttgart ended in 1941 when the Jewish Nurses' Home was dissolved by the Nazis and four nurses were murdered in concentration camps.
Eickhoff, Jens; Cook, Barry; Walker, Paul; Habinc, Sadi; Witt, Rouven; Roser, Hans-Peter
As already published in another paper at DASIA 2010 in Budapest  the University of Stuttgart, Germany, is developing an advanced 3-axis stabilized small satellite applying industry standards for command/control techniques, onboard software design and onboard computer components.The satellite has a launch mass of approx. 120kg and is foreseen to be launched end 2013 as piggy back payload on an Indian PSLV launcher.During phase C the main challenge was the conceptual design for an ultra compact and performant onboard computer (OBC), which is able to support an industry standard operating system, a PUS standard based onboard software (OBSW) and CCSDS standard based ground/space communication. The developed architecture is based on 4 main elements (see  and Figure 4):• the OBC core board (single board computer based on LEON3 FT architecture),• an I/O Board for all OBC digital interfaces to S/C equipment,• a CCSDS TC/TM pre-processor board,• CPDU being embedded in the PCDU.The EM for the OBC core meanwhile has been shipped to the University by the supplier Aeroflex Colorado Springs, USA and is in use in Stuttgart since January 2011. Figure 2 and Figure 3 provide brief impressions. This paper concentrates on the common design of the I/O board and the CCSDS processor boards.
Martin, Jan M. L.; Sundermann, Andreas
We propose large-core correlation-consistent (cc) pseudopotential basis sets for the heavy p-block elements Ga-Kr and In-Xe. The basis sets are of cc-pVTZ and cc-pVQZ quality, and have been optimized for use with the large-core (valence-electrons only) Stuttgart-Dresden-Bonn (SDB) relativistic pseudopotentials. Validation calculations on a variety of third-row and fourth-row diatomics suggest them to be comparable in quality to the all-electron cc-pVTZ and cc-pVQZ basis sets for lighter elements. Especially the SDB-cc-pVQZ basis set in conjunction with a core polarization potential (CPP) yields excellent agreement with experiment for compounds of the later heavy p-block elements. For accurate calculations on Ga (and, to a lesser extent, Ge) compounds, explicit treatment of 13 valence electrons appears to be desirable, while it seems inevitable for In compounds. For Ga and Ge, we propose correlation consistent basis sets extended for (3d) correlation. For accurate calculations on organometallic complexes of interest to homogenous catalysis, we recommend a combination of the standard cc-pVTZ basis set for first- and second-row elements, the presently derived SDB-cc-pVTZ basis set for heavier p-block elements, and for transition metals, the small-core [6s5p3d] Stuttgart-Dresden basis set-relativistic effective core potential combination supplemented by (2f1g) functions with exponents given in the Appendix to the present paper.
Kempka, Thomas; Norden, Ben; Ivanova, Alexandra; Lüth, Stefan
Pilot-scale carbon dioxide storage has been performed at the Ketzin pilot site in Germany from June 2007 to August 2013 with about 67 kt of CO2 injected into the Upper Triassic Stuttgart Formation. In this context, the main aims focussed on verification of the technical feasibility of CO2 storage in saline aquifers and development of efficient strategies for CO2 behaviour monitoring and prediction. A static geological model has been already developed at an early stage of this undertaking, and continuously revised with the availability of additional geological and operational data as well as by means of reservoir simulations, allowing for revisions in line with the efforts to achieve a solid history match in view of well bottomhole pressures and CO2 arrival times at the observation wells. Three 3D seismic campaigns followed the 2005 3D seismic baseline in 2009, 2012 and 2015. Consequently, the interpreted seismic data on spatial CO2 thickness distributions in the storage reservoir as well as seismic CO2 detection limits from recent conformity studies enabled us to enhance the previous history-matching results by adding a spatial component to the previous observations, limited to points only. For that purpose, we employed the latest version of the history-matched static geological reservoir model and revised the gridding scheme of the reservoir simulation model by coarsening and introducing local grid refinements at the areas of interest. Further measures to ensure computational efficiency included the application of the MUFITS reservoir simulator (BLACKOIL module) with PVT data derived from the MUFITS GASSTORE module. Observations considered in the inverse model calibration for a simulation time of about 5 years included well bottomhole pressures, CO2 arrival times and seismically determined CO2 thickness maps for 2009 and 2012. Pilot points were employed by means of the PEST++ inverse simulation framework to apply permeability multipliers, interpolated by kriging
Rodriguez, J H; Pignata, M L; Fangmeier, A; Klumpp, A
The accumulation of polycyclic aromatic hydrocarbons (PAHs) in Tillandsia capillaris Ruiz and Pav. form capillaris and trace elements in T. capillaris and Lolium multiflorum (LAM) cv. Lema was assessed and evaluated in the city of Stuttgart, Germany. Several sites (urban, suburban and rural) categorized according to type and intensity of vehicular traffic were investigated. At these sites, plants of T. capillaris and standardized cultures of L. multiflorum were exposed to ambient air. Foliar concentrations of PAHs (16 priority pollutants according to US-EPA) and of the trace elements Br, Co, Cu, Fe, Mn, Ni, Pb and Zn were determined. A high level of vehicular traffic was associated with the largest concentrations of PM(10) in ambient air and with the highest contents of PAHs and heavy metals in the bioindicator plants. The results showed a similar pattern between T. capillaris and the standardized biomonitor L. multiflorum. Therefore, these results allow us to propose T. capillaris as a suitable bioindicator to assess the distribution of pollution impacts caused by PAHs and trace elements in different subtropical and tropical regions. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
Rogowska, Justyna; Wolska, Lidia; Namieśnik, Jacek
In 1943 the German hospital ship s/s Stuttgart (Lazaretschiff "C") was sunk close to the port of Gdynia (Gulf of Gdańsk - Polish coast). This and other actions (undertaken after the war to remove the wreck) led to pollution of the sea bottom with oil derivatives. During our studies (2009) 11 surface sediment and water samples were collected as well as sediment core samples at 4 locations in order to determine the concentration levels of priority pollutants belonging to polycyclic aromatic hydrocarbons (PAH) and polychlorinated biphenyls (PCB). The concentrations of 16 PAH and 7 PCB were analysed with GC-MS. ΣPAH varied between 11.54 ± 0.39 and 206.7 ± 6.5mg/kg dry weight in the surface sediments, and from 0.686 ± 0.026 to 1291 ± 53 mg/kg dry weight in the core samples. Contamination in the core samples collected may reach a depth of at least 230-240 cm (deepest sample studied). The PAH-group profiles in all surface sediment samples suggest a pyrolytic source of PAH, while the results obtained for core samples indicate a mixed pattern of pyrolytic and petrogenic inputs of PAH. Results obtained may suggest also that fuel residues being present at sea bottom is not crude oil derived but results from coal processing (synthetic fuel). The sum of PCB in surface sediments ranged from 0.761 ± 0.068 to 6.82 ± 0.28 μg/kg dry weight (except for sampling point W2, where ΣPCB was 108.8 ± 4.4 μg/kg dry weight). The strong correlation between PAH and PCB levels, and the fact that PCB are present only in the surface sediments, suggest that the compounds in these sediments got there as a result of emission from urban areas, entering the aquatic environment via atmospheric deposition. PCB levels in the sediment core samples were generally very low and in most cases did not exceed the method quantification limit. Copyright © 2010 Elsevier B.V. All rights reserved.
Evidence of seasonal variation in longitudinal growth of height in a sample of boys from Stuttgart Carlsschule, 1771-1793, using combined principal component analysis and maximum likelihood principle.
Lehmann, A; Scheffler, Ch; Hermanussen, M
Recent progress in modelling individual growth has been achieved by combining the principal component analysis and the maximum likelihood principle. This combination models growth even in incomplete sets of data and in data obtained at irregular intervals. We re-analysed late 18th century longitudinal growth of German boys from the boarding school Carlsschule in Stuttgart. The boys, aged 6-23 years, were measured at irregular 3-12 monthly intervals during the period 1771-1793. At the age of 18 years, mean height was 1652 mm, but height variation was large. The shortest boy reached 1474 mm, the tallest 1826 mm. Measured height closely paralleled modelled height, with mean difference of 4 mm, SD 7 mm. Seasonal height variation was found. Low growth rates occurred in spring and high growth rates in summer and autumn. The present study demonstrates that combining the principal component analysis and the maximum likelihood principle enables growth modelling in historic height data also. Copyright (c) 2009 Elsevier GmbH. All rights reserved.
Aquaculture (fish farming) has played an ever-increasing role in providing people with fish, shrimp, and shellfish. Aquaculture is currently the fastest growing sector of global food production and in 2014 totaled 80 million tons valued at $140 billion. The production of food-fish from aquaculture...
Aquaculture (fish farming) has played an ever-increasing role in providing people with fish, shrimp, and shellfish. Aquaculture is currently the fastest growing sector of global food production and in 2016 totaled 90 million tons valued at $180 billion. The production of food-fish from aquaculture...
appropriate throughout the report and provided a copy of management officials with this report. 20130205-012589 3 II. BACKGROUND On July 15, 2010,Com15...subject in the case. Accordingly, we did not consider RDML Losey a responsible management official in this report. Reduced Performance Award – Yes...AFRICOM Special Operations Instrnction] 1400.02, DoD FMR [Financial Management Re lation not cited and AFRICOM Policy Directives on Finding 4
In 1958, Congress enacted the Fish Rice Rotation Act that directed the Secretary of the Interior (in cooperation with USDA) to develop a program to solve problems related to production and harvest of warmwater fish. The idea was to establish a program to grow fish on flooded rice acreage in rotatio...
Among the topics discussed are: drift and scale factor tests on the SEL fiber gyro; integrated optical rate sensor development; and the beam geometry of a ring laser gyro in relation to its performance. Consideration is also given to: a fast filtering technique for measuring random walk in a laser gyro; vibratory gyroscopic sensors; a redundant strapdown reference for advanced aircraft flight control systems; and a low-cost piezoelectric rate/acceleration sensor. Additional topics include: an inertial guidance system for a Low-Earth-Orbit (LEO) vehicle; and signal disturbance effects in a strapdown northfinder.
Reinsch, K. G. (Editor); Schmidt, W. (Editor); Ecer, A. (Editor); Haeuser, Jochem (Editor); Periaux, J. (Editor)
A conference was held on parallel computational fluid dynamics and produced related papers. Topics discussed in these papers include: parallel implicit and explicit solvers for compressible flow, parallel computational techniques for Euler and Navier-Stokes equations, grid generation techniques for parallel computers, and aerodynamic simulation om massively parallel systems.
This innovative technology evaluation report (ITER) summarized the results of an evaluation of a surfactant-enhanced extraction technology. This evaluation was conducted under a bilateral agreement between the United States (U.S.) Environmental Protection Agency (EPA) Superfund ...
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The concepts of software engineering which allow a user of the finite element method to describe a model, to collect and to check the model data in a data base as well as to form the matrices required for a finite element calculation are examined. Next the components of the model description are conceived including the mesh tree, the topology, the configuration, the kinematic boundary conditions, the data for each element, and the loads. The possibilities for description and review of the data are considered. The concept of the segments for the modularization of the programs follows the components of the model description. The significance of the mesh tree as a globular guiding structure will be understood in view of the principle of the unity of the model, the mesh tree, and the data base. The user-friendly aspects of the software system will be summarized: the principle of language communication, the data generators, error processing, and data security.
Recent advances in the analytical and numerical treatment of physical and engineering problems are discussed in reviews and reports. Topics addressed include fluid mechanics, numerical methods for differential equations, FEM approaches, and boundary-element methods. Consideration is given to optimization, decision theory, stochastics, actuarial mathematics, applied mathematics and mathematical physics, and numerical analysis.
Recent experimental, theoretical, and numerical investigations of problems in applied mechanics are discussed in reviews and reports. The fields covered include vibration and stability; the mechanics of elastic and plastic materials; fluid mechanics; the numerical treatment of differential equations; finite and boundary elements; optimization, decision theory, stochastics, and actuarial analysis; applied analysis and mathematical physics; and numerical analysis. Reviews are presented on mathematical applications of geometric-optics methods, biomechanics and implant technology, vibration theory in engineering, the stiffness and strength of damaged materials, and the existence of slow steady flows of viscoelastic fluids of integral type.
the large veiis in the legs and splanchnic region via the carotid sinus baroceptor reflex, and the distensibility charac- teristics of these veins (14...conditioning, by improving anaerobic capacity and muscular strength, has been shown in three separate studies to increase G-duration tolerance--in one study...field study, USN pilots found anaerobic and muscular conditioning particularly beneficial in improving their ACM tolerance (39). The USAF encourages
Chen, Mo; Jiang, He-Long
Iron reduction is one of the important organic matter (OM) mineralization pathway in sediments. Here we investigated the rates and the relative contribution of iron reduction to OM mineralization in Zhushan bay (ZSB, cyanobacterial bloom biomass (CBB)-dominated habitats) and East Taihu Lake (ETL, submerged macrophypes (SM)-dominated habitats) of Lake Taihu, China. Anaerobic microcosm incubation revealed that the rate of iron reduction at ZSB (4.42 μmol cm(-3) d(-1)) in summer was almost 1.5 times higher than at ETL (3.13 μmol cm(-3) d(-1)). Iron reduction accounted for 66.5% (ZSB) and 31.8% (ETL) of total anaerobic carbon mineralization, respectively. No detectable methanogenesis was found at ZSB, while methanogenesis was responsible for 16.7% of total anaerobic respiration in sediments of ETL. Geochemical analysis of solid phase constituents indicated that ZSB surface sediments experienced highly oxidizing conditions with much higher amorphous Fe(III) (71 mmol m(-2)) than ETL (11 mmol m(-2)). Conversely, AVS inventories at ETL (38 mmol m(-2)) were up to 30 times higher than at ZSB (1.27 mmol m(-2)), indicating significant sulfate reduction in sediments of ETL. Overall results suggested that varying carbon sources and distinct geochemical characterizations of the sediments in contrasting habitats significantly influenced the rate of iron reduction and the pathway of C mineralization in a large freshwater lake. Copyright © 2016 Elsevier Ltd. All rights reserved.
Röhrig, Gabriele; Gütgemann, Ines; von Gersdorff, Gero; Polidori, Maria Cristina; Lupescu, Adrian; Lang, Florian; Kolb, Gerald
Anemia in advanced age is often a multifactorial condition requiring an interdisciplinary approach. The contributions to the opening interdisciplinary symposium on anemia in older subjects focused on physiological and histopathological as well as on nephrological and neurogeriatric aspects and on the therapeutic implications of this underdiagnosed, yet highly frequent disease. The symposium was the kick-off event for the founding of the German Geriatric Society special interest group on anemia in advanced age.
Nasser, Ramzi; Othmen, Walid Ben Haj; Elhouichet, Habib; Férid, Mokhtar
In the present study, undoped and antimony (Sb) doped ZnO nanocrystals (NCs) were prepared by a simple and economical sol-gel method. X-ray diffraction (XRD) and transmission electron microscopy (TEM) revealed the purity of the obtained phase and its high crystallinity. Raman analysis confirms the hexagonal Wurtzite ZnO structure. According to the diffuse reflectance results, the band gap was found to decrease up to 3% of Sb doping (ZSb3 sample). The results of X-ray photoelectron spectroscopy (XPS) measurements reveal that Sb ions occupied both Zn and interstitials sites. The successful substitution of antimony in ZnO lattice suggests the formation of the complex (SbZn-2 VZn) acceptor level above the valence band. Particularly for ZSb3 sample, the UV photoluminescence (PL) band presents an obvious red-shift attributed to the formation of this complex. Rhodamine B (RhB) was used to evaluate the photocatalytic activity of Sb-doped ZnO NCs under sunlight irradiation. It was found that oxygen vacancies play a major role in the photocatalytic process by trapping the excited electrons and inhibiting the radiative recombination. During the photocatalytic mechanism, the Sb doping, expressed through the apparition of the (SbZn-2 VZn) correspondent acceptor level, enhances the sunlight absorption within the ZnO band gap, which stimulates the generation of hydroxyl radicals and promotes the photocatalytics reaction rates. Such important contribution of the hydroxyl radicals was confirmed experimentally when using ethanol as scavenger in the photocatalytic reaction. The photodegradation experiments reveal that ZSb3 sample exhibits the highest photocatalytic activity among all the prepared samples and presents a good cycling stability and reusability. The influence of the initial pH in the photodegradation efficiency was also monitored and discussed.
characterized a 45 kDa "ZSB, de!•ignted S’SB1, most extensively. SSB1 was isolated on the basis of preferential binding to sin ie-stranded versus double...stranded DNA and was subsequently shown also to bind to RNA (9). Although SSB1 seems to bind without sequen-e specificity, it is interesting to note...that it copurifies through several a inity steps with the yeast poly (A) binding protein (11, Sach3 and Jong, unpublished observations). SSB1 stimulates
Costerousse, Benjamin; Schönholzer-Mauclaire, Laurie; Frossard, Emmanuel; Thonar, Cécile
Soil and plant inoculation with heterotrophic zinc-solubilizing bacteria (ZSB) is considered a promising approach for increasing zinc (Zn) phytoavailability and enhancing crop growth and nutritional quality. Nevertheless, it is necessary to understand the underlying bacterial solubilization processes to predict their repeatability in inoculation strategies. Acidification via gluconic acid production remains the most reported process. In this study, wheat rhizosphere soil serial dilutions were plated on several solid microbiological media supplemented with scarcely soluble Zn oxide (ZnO), and 115 putative Zn-solubilizing isolates were directly detected based on the formation of solubilization halos around the colonies. Eight strains were selected based on their Zn solubilization efficiency and siderophore production capacity. These included one strain of Curtobacterium , two of Plantibacter , three strains of Pseudomonas , one of Stenotrophomonas , and one strain of Streptomyces In ZnO liquid solubilization assays, the presence of glucose clearly stimulated organic acid production, leading to medium acidification and ZnO solubilization. While solubilization by Streptomyces and Curtobacterium was attributed to the accumulated production of six and seven different organic acids, respectively, the other strains solubilized Zn via gluconic, malonic, and oxalic acids exclusively. In contrast, in the absence of glucose, ZnO dissolution resulted from proton extrusion (e.g., via ammonia consumption by Plantibacter strains) and complexation processes (i.e., complexation with glutamic acid in cultures of Curtobacterium ). Therefore, while gluconic acid production was described as a major Zn solubilization mechanism in the literature, this study goes beyond and shows that solubilization mechanisms vary among ZSB and are strongly affected by growth conditions. IMPORTANCE Barriers toward a better understanding of the mechanisms underlying zinc (Zn) solubilization by bacteria
Recent discoveries of topological semimetals have generated immense interests since they represent new topological states of quantum matters. In this talk, I will present our recent studies on topological semimetals, which are focused on Dirac/Weyl fermions generated by square lattices in layered compounds. I will first report on our discoveries of two new Dirac materials Sr1-yMn1-zSb2 and BaMnSb2 in which nearly massless Dirac fermions are generated by 2D Sb layers. In Sr1-yMn1-zSb2, Dirac fermions are found to coexist with ferromagnetism, offering a rare opportunity to investigate the interplay between relativistic fermions and spontaneous time reversal symmetry breaking and explore a possible magnetic Weyl state. Then I will show our quantum oscillation studies on two new Dirac nodal line semimetals - ZrSiSe and ZrSiTe. We have not only revealed their signatures of nodal-line fermions, but also demonstrated that their atomically thin crystals are accessible via mechanical exfoliation, raising the possibility of realizing the theoretically predicted 2D topological insulators. Finally I will discuss exotic quantum transport behavior arising from the zeroth Landau level in Weyl semimetal YbMnBi2. This work is supported by the U.S. DOE under Grant No. DE-SC0014208 (support for the work on ZrSiSe and ZrSiTe) and DOE-EPSCoR Grant No. DE-SC0012432 with additional support from the Louisiana BoR (support for the work on (Sr/Ba)MnSb2 and YbMnBi2).
Drobinski, P.; Bastin, S.; Dabas, A.; Delville, P.; Reitebuch, O.
Sea-breeze dynamics in southern France is investigated using an airborne Doppler lidar, a meteorological surface station network and radiosoundings, in the framework of the ESCOMPTE experiment conducted during summer 2001 in order to evaluate the role of thermal circulations on pollutant transport and ventilation. The airborne Doppler lidar WIND contributed to three-dimensional (3-D) mapping of the sea breeze circulation in an unprecedented way. The data allow access to the onshore and offshore sea breeze extents (xsb), and to the sea breeze depth (zsb) and intensity (usb). They also show that the return flow of the sea breeze circulation is very seldom seen in this area due to (i) the presence of a systematic non zero background wind, and (ii) the 3-D structure of the sea breeze caused by the complex coastline shape and topography. A thorough analysis is conducted on the impact of the two main valleys (Rhône and Durance valleys) affecting the sea breeze circulation in the area.
Finally, this dataset also allows an evaluation of the existing scaling laws used to derive the sea breeze intensity, depth and horizontal extent. The main results of this study are that (i) latitude, cumulative heating and surface friction are key parameters of the sea breeze dynamics; (ii) in presence of strong synoptic flow, all scaling laws fail in predicting the sea breeze characteristics (the sea breeze depth, however being the most accurately predicted); and (iii) the ratio zsb/usb is approximately constant in the sea breeze flow.
Ueta, K.; Tani, K.
shears and pressure ridges, and left-stepping and right-stepping pressure ridges are observed. d) With displacement concentrated on the central throughgoing fault zone, a "Zone of shear band" (ZSB) developed directly above the basement fault. The geometry of the ZSB shows a strong resemblance to linear ridge and trough geomorphology associated with active strike-slip faulting. (3) In the case of normal faulting, the location of the surface fault rupture is just above the bedrock faults, which have no relationship with the fault dip. On the other hand, the location of the surface rupture of the reverse fault has closely relationship with the fault dip. In the case of strike-slip faulting, the width of the deformation zone in dense sand is wider than that in loose sand. (4) The horizontal distance of surface rupture from the bedrock fault normalized by the height of sand mass (W/H) does not depend on the height of sand mass and grain size of sand. The values of W/H from the test agree well with those of earthquake faults. (5) The normalized base displacement required to propagate the shear rupture zone to the ground surface (D/H), in the case of normal faulting, is lower than those for reverse faulting and strike-slip faulting.
German Deligation visits Ames SOFIA Science Office for briefing. Left to right Jochen Homann, German State Secretary Federal Ministry of Economics and Technology, and Manuel Wiedemann, post-doctorate student from the Deutsches SOFIA Institute, University of Stuttgart.
Studies were conducted to determine aspects of water chemistry responsible for large differences in pathogenesis and mortality rates in challenges of channel catfish Ictalurus punctatus with Flavobacterium columnare; challenges were conducted in water supplying the Stuttgart National Aquaculture Res...
Zhang, P; Jiang, G; Xie, B; Ding, J
Lung hernia is an extremely rare condition and the treatments vary. We report a case of cervical lung hernia without any trauma. The patient underwent video-assisted repair with a satisfactory result. Georg Thieme Verlag KG Stuttgart New York.
Vibrations Stimulated by Lateral Forces in Sealing Gaps," In German, Institut ffir Thermische Str ~mungsmaschinen, Unwersitat Stuttgart. 26. Warner, R. E...investigations at the "Institut fOr Thermische Str ~mungsmaschinen at the Uni- versity of Stuttgart" are performed. This is done with the aim to point out the...Eigenschwingungen von Turbinenlaufern, angefacht durch die Spaltstr~ mung in Stopfbuchsen und Beschauflungen. Bull. de l’AIM 71 (1958) pp. 1039-1063 4
Propulsion and Energetics Panel Working Group 23 on Guide to the Measurement of the Transient Performance of Aircraft Turbine Engines and Components (Guide pour la mesure des performances en transitoire des turbomachines Aeronautiques et de leurs composants)
Oft-«) D-mt) Munich 50 Prof. Dring. Wolfgang Braig Universität Stuttgart Institut für Luftfahrtantriebe Pfaffenwaldring 6 D-7000 Stuttgart 80...Symposium, May, 1977. 3.20 MQff»t,R.J., Designing Thermocouples for Response Rate, ASME Paper No. 57-CTP-8. 3.21 Glawe, G.E., Holanda, R., and Krause ...Science and Industry, Vol.3, Part 2, 1962. 4.3.3 Glawe, G.E., Holanda, R., Krause , L.N., Recovery and Radiation Corrections and Time Constants of
Prommersberger, K-J; Giunta, R E
This paper describes from the editors' perspective step-by-step how to configure and write a manuscript for the Handchirurgie Mikrochirurgie Plastische Chirurgie with the goal to make a successful and quick publication easier. © Georg Thieme Verlag KG Stuttgart · New York.
Six new vocational agriculture curriculum guides which are being developed at Stuttgart High School in Arkansas will cover the following instructional areas: soybean and rice production, horticulture, farm buildings design and layout, agriculture metal working, agricultural farm building and structures, and farm machinery. (BM)
VON BARAVALLE, HERMANN
AN HISTORICAL REVIEW OF THE WALDORF SCHOOL PLAN TRACES THE MOVEMENT FROM ITS FOUNDING IN STUTTGART, GERMANY IN 1919, BY THE WALDORF ASTORIA COMPANY AND UNDER THE DIRECTION OF RUDOLF STEINER, TO ITS INTRODUCTION INTO SWITZERLAND, OTHER EUROPEAN COUNTRIES, THE AMERICAS, AUSTRALIA, NEW ZEALAND, AND SOUTH AFRICA, A TOTAL OF 175 SCHOOLS AS OF 1963. THE…
Izadpanah, Ali; Viezel-Mathieu, Alex; Izadpanah, Arash; Luc, Mario
Dupuytren contracture of the palm is a relatively common benign fibroproliferative disease of the palmar fascia typically affecting the adult population. There have however been several reported cases of Dupuytren contracture in children. We sought to review the literature for Dupuytren contracture and highlight the main clinical features and management of the disease in children. Georg Thieme Verlag KG Stuttgart · New York.
Germany Germany Flag of Djibouti Djibouti Flag of Afghanistan Afghanistan Top Stories Carter Wraps Up , Civilians Breedlove Takes Charge at European Command Carter Arrives in Germany for Eucom Change of Command Meetings Carter Attends Eucom Change of Command Ceremony in Stuttgart, Germany Travel Locations Travel
Walter, U; Bisson, S; Gerken, U; Machleidt, W; Krauth, C
Based on a sample of the Hannover registration office this project analyses the health and prevention behaviour of Russian- and Turkish-language migrants compared to natives. The project analysis revealed considerable differences, particularly concerning addiction behaviour and physical activities. © Georg Thieme Verlag KG Stuttgart · New York.
Kindler, C; Lukas, B
We report a case of an 80-year-old woman with an acute carpal tunnel syndrome. This was based on an acute episode of chondrocalcinoses and accompagnied by a prolaps of the median nerve into a gap of the forearm fascia as result of a cut injury in childhood. © Georg Thieme Verlag KG Stuttgart · New York.
Alternate wetting and drying (AWD) cycles offer potential savings in water use for paddy rice production while reducing both greenhouse gas emissions and lowering grain arsenic content. In a three-year (2011-2013) field study near Stuttgart, AR, one-third of a field previously grown to soybean was b...
executive overview, IBM System Service, Stuttgart. 2. Doyen, P., 1987. Analyse d’opportunite et aspects fonctionnels d’une gestion integree par un systeme...Inst. di Astron. Tucson, AZ 85726-6732 Campus do Vale Citta. Universitaria 90049 Porto Alegre RS Viale A. Doris Mo. Vagiawari Alladi BRAZIL 1-95125
The meaning of epiphenomenalism for psychosomatic medicine and psychotherapy is analyzed. It may be concluded that Ernst-August Dölle was one of the first researchers to describe and to use the Alpha and Omega of epiphenomenalism. Georg Thieme Verlag KG Stuttgart · New York.
Review of: Fish Immunology. Edited by M. J. Manning and M. F. Tatner. Academic Press, London. 1985. 374 pages. $32.50. Reviewed by B. R. Griffin, Fish Farming Experimental Station, U.S. Fish and Wildlife Service, Stuttgart, Arkansas 72160, USA.
Jahn, I; Böttcher, S
This outcome evaluation study has investigated different diet concepts in day-care centres and their effects on health-related dietary behaviour of children and their families. No advantage of a certain approach to manage food and diet-related activities in day-care centres could be shown. © Georg Thieme Verlag KG Stuttgart · New York.
German Deligation visits Ames SOFIA Science Office for briefing. Left to right Jochen Homann, German State Secretary Federal Ministry of Economics and Technology, Dr. Benno Bunse, President & CEO, German American Chamber of Commerce, New York, Manuel Wiedemann, post-doctorate student from the Deutsches SOFIA Institute, University of Stuttgart.
Cole, Theresa S; McKendrick, Fiona; Cant, Andrew J; Pearce, Mark S; Cale, Catherine M; Goldblatt, David R; Gennery, Andrew R; Titman, Penny
Chronic granulomatous disease (CGD) is a primary immunodeficiency managed conservatively or with hematopoietic stem cell transplant. Studies have shown people with CGD and those transplanted for primary immunodeficiencies have lower than average cognitive ability. In this study, IQ in children with CGD and those transplanted for it was within the normal range. Georg Thieme Verlag KG Stuttgart · New York.
Wick, Matthias; Schneiker, André; Bele, Sylvia; Pawlik, Michael; Meyringer, Helmut; Graf, Bernhard; Wendl, Christina; Kieninger, Martin
We report on a patient who developed a space-occupying cerebellar infarction with occlusive hydrocephalus after a poisoning with carbon monoxide with the intention to commit suicide. A neurosurgical and intensive care therapy were needed. The patient's survival without severe neurological deficits could be secured due to the early detection of the intracerebral lesions. Georg Thieme Verlag KG Stuttgart · New York.
The Genetic Stocks Oryza (GSOR) Collection was established in 2004 at the USDA-ARS, Dale Bumpers National Rice Research Center (DBNRRC) located in Stuttgart, AR. The mission of GSOR is to provide unique genetic resources to the rice research community for genetic and genomics related research. GSOR ...
1995 Dasa-DA Hot Metallic Structure Dasa-LM Raufoss A/S (N) NBL Partner Plansee (A) *) HTP, initiated 1988 and sponsored by the German Federal Ministry...Dornier NBL Partner TsAGI (Gus) VOLVO (S) CIAM (GUS) NBL Partner VOLVO (S) AEDC (US) VOLVO (S) Dasa-RI Dasa-LM TU Stuttgart RWTH Aachen DLR TsAGI (GUS
Grieshop, M; Schücking, B
Maternal stress and lack of social support in the postpartum period have a negative impact on health behaviour of new mothers. Midwives can enhance mother's coping with stress and improve their social support by early interventions in postpartum care. © Georg Thieme Verlag KG Stuttgart · New York.
Four commercially available spatial repellent devices were tested in a rice land habitat near Stuttgart, Arkansas after semi-field level assessments had been made at the Center for Medical, Agricultural, and Veterinary Entomology, ARS, USDA in Gainesville, FL. OFF! Clip-On® (a.i. metofluthrin, S.C....
Kesting, Julie R; Staerk, Dan; Tejesvi, Mysore V; Kini, Kukkundoor R; Prakash, Harishchandra S; Jaroszewski, Jerzy W
HPLC-SPE-NMR analysis of a crude extract of fermentation broth of cultured PESTALOTIOPSIS VIRGATULA isolate TC-320 from TERMINALIA CHEBULA Retz. (Combretaceae) disclosed the presence of a simple but unprecedented low-molecular-weight metabolite, 9-hydroxybenzo[ C]oxepin-3[1 H]-one, subsequently isolated by a targeted purification procedure. Georg Thieme Verlag KG Stuttgart.New York.
Stanford Univ., CA.
Closeup studies of German life in the Stuttgart area are reported here by 79 participants of Stanford University's 1963 National Defense Education Act Second-Level Institute for Elementary and Secondary School Teachers held at Bad Boll, Germany. Elementary and secondary education, work and family life, and housing and housing developments are…
using an Eikonix camera linked to the Vax Station 3200. § 3. RESULTS AND DISCUSSION In this section, results are reported and discussed for four aspects... GESELLS ( HA ~FU ~(R NIET’ALLK1 DE EN. ~ DR. RIEDERER-VERLAG GMBH POSTFACH 104052 7000 STUTTGART I Bd. 81 (1990) H 10 Spinel Interphase Formation at NU
Sidhu, Paul S; Cantisani, Vito; Dietrich, Christoph F; Gilja, Odd Helge; Saftoiu, Adrian; Bartels, Eva; Bertolotto, Michele; Calliada, Fabrizio; Clevert, Dirk-André; Cosgrove, David; Deganello, Annamaria; D'Onofrio, Mirko; Drudi, Francesco Maria; Freeman, Simon; Harvey, Christopher; Jenssen, Christian; Jung, Ernst-Michael; Klauser, Andrea Sabine; Lassau, Nathalie; Meloni, Maria Franca; Leen, Edward; Nicolau, Carlos; Nolsoe, Christian; Piscaglia, Fabio; Prada, Francesco; Prosch, Helmut; Radzina, Maija; Savelli, Luca; Weskott, Hans-Peter; Wijkstra, Hessel
The updated version of the EFSUMB guidelines on the application of non-hepatic contrast-enhanced ultrasound (CEUS) deals with the use of microbubble ultrasound contrast outside the liver in the many established and emerging applications. © Georg Thieme Verlag KG Stuttgart · New York.
Dr R. Klemm DrD Rother FGAN- FFM SEL/LS/E Neuenahrer Strasse 20 Lorenzstrasse 10 D-5307 Wachtberg 7 D-7000 Stuttgart 40 Germany Germany Prof. G...des solutions. accas I lFionograinme, donc: aui profil. Cat article rapporte tine partie des Etudes mendes an La indthodo proposde s’inspirc de cette
Bönhof, Leoni; Steffgen, Ludwig; Bönhof, Jörg
Step by step explanation and detailed overview of the correct approach to spectral-Doppler-sonography, including several practical examples. The article provides comprehensive explanations of the appropriate settings in different situations. © Georg Thieme Verlag KG Stuttgart · New York.
Geschicbte der Stammdivision der Waffen -SS, Band V: 194 -1945. Osnabruck: Munln-Verlag, 1982. (Includes translation) (Stuttgart] 105 Weidinger, Otto, ed...1960. C -68 Weidinger, Otto. Division Das Reich. Der Weg der 2.SS Panzer-Division "Das Reich". Die Geschichte der Stammdivision der Waffen -SS, Band
von Weizsäcker, F; Maio, G
The current DRG system has not only changed the economic structure of clinical medicine but also has profound effects on its original mission. In the present paper we discuss the fundamental limits of the DRG system and make a case for placing more emphasis on time and communication in health care. Georg Thieme Verlag KG Stuttgart. New York.
Stilwell, William E.; Barclay, James R.
This is an evaluation of developmental guidance services' affective education program. Data was collected on children enrolled in Buerkle School and in a control school (Julia Shannon) in Stuttgart School District No. 22 (AR). Third- and fourth-grade level boys and girls who had been in the program for the full 1975-1976 year provided data for…
Stilwell, William E.; Barclay, James R.
This report describes the effects of a 2-year affective-social education program offered by the elementary guidance services of the Stuttgart School District in Arkansas. Four groups of children (a total of 105 boys and 116 girls) were identified for this evaluation: Group I, involved in the program for two full years; Group II, participating one…
Stilwell, William E.
This study compared the effects of the Stuttgart School District's developmental guidance program with the effects of one of its traditional school programs on children's affective-social development. Affective education data were collected at the end of third grade (May, 1975) and again at the end of fourth grade (May, 1976) for 58 boys and 47…
Kim, Young; Schmidt-Wolf, Ingo G H
In 1994, the first clinical gene therapy trial was performed in Germany. Since then more than 2000 clinical gene therapy trials have been performed worldwide. After 20 years, a short résumé is drawn here. © Georg Thieme Verlag KG Stuttgart · New York.
Zeus, Tobias; Kelm, Malte; Bode, Christoph
Thrombo-embolic prophylaxis is a key element within the therapy of atrial fibrillation/atrial flutter. Besides new oral anticoagulants the concept of left atrial appendage occlusion has approved to be a good alternative option, especially in patients with increased risk of bleeding. © Georg Thieme Verlag KG Stuttgart · New York.
Wulf, Volker; Schinzel, Britta
This paper reports on a pilot project in which German universities in Freiburg, Constance, Mannheim, Stuttgart, and Ulm connected computer science departments via the Internet for a summer 1997 telelecture and teletutorial on computers and society. The first section provides background on telelearning and introduces the case study. The second…
This article describes an alternative suture technique for thoracotomy incisions. A modified mattress suture technique is used to fix the intercostal muscles. The described technique can prevent rib fractures and reduce the incidence of intercostal nerve injury. Also, this technique is easy to perform and is effective. Georg Thieme Verlag KG Stuttgart · New York.
Wiedmann, Werner; Hölzel, Maria
The machines mainly used for compounding plastics, chemicals and food are co-rotating, closely intermeshing twin-screw extruders. Some 30 000 such extruders are in use worldwide, about 1/3 are ZSKs from Coperion Werner & Pfleiderer, Stuttgart. In the chemical industry more and more batch mixers are being replaced by continuous twin-screw kneaders.
Stilwell, William E.; Barclay, James R.
This report describes a 12-week pilot phase of an affective education program in the Stuttgart School District, Arkansas. Participating in the program were 218 children, grades 2-4, and a team of nineteen teachers who were given 12 weeks of in-service training designed to facilitate their use of the DUSO, Focus on Self-Development Human…
Dieks, J-K; von Bueren, A O; Schaefer, I-M; Menke, J; Lex, C; Krause, U; Zenker, D; Kühnle, I; Kramm, C M
We report on a case of Pseudomonas aeruginosa sepsis and consecutive lung abscess in a 13-year-old patient with acute B-cell leukemia. At first, radiographic findings strongly suggested presence of pulmonary aspergilloma and only microbiological testing of the surgically enucleated mass revealed the correct underlying pathogen and confirmed final diagnosis. © Georg Thieme Verlag KG Stuttgart · New York.
Grunze, Anna; Mago, Rajnish; Grunze, Heinz
Psychotropics are highly effective medications that, however, have adverse drug reactions attached to them. They are indispensable for many patients. How to cope with side effects - watchful waiting, dose reduction, change of medication, addition of an "antidote" and behavioural modifications - depends on their nature, severity and finally the patients wish. This review is meant to aid clinician's and patient's decisions in case of the occurrence of compromising, frequent adverse drug reactions. © Georg Thieme Verlag KG Stuttgart · New York.
Li, Wei; Yang, Ya-Bin; Yang, Xue-Qiong; Xie, Hui-Ding; Shao, Zhi-Hui; Zhou, Hao; Miao, Cui-Ping; Zhao, Li-Xing; Ding, Zhong-Tao
The rare anishidiol and five new isochromans, including three novel dimers with unprecedented skeletons, were isolated from Stachybotrys sp. PH30583. Their structures were determined by spectral analyses. The bioactivities of these compounds were also investigated. The dimers ( 6 - 10 ) inhibited acetylcholinesterase at 50 µM, but the monomers did not. To investigate the biogenesis of the novel dimers, a time-course investigation of metabolite production was undertaken. Georg Thieme Verlag KG Stuttgart · New York.
Stiawa, Maja; Kilian, Reinhold; Becker, Thomas
Systematic review of psychosocial interventions for high-risk family members with mental health problems in highly developed industrialized countries. Systematic search in electronic databases as well as manual search for intervention studies. Interventions were effective in significantly reducing symptoms of depression and anxiety and strengthening social skills. Backing in situations of distress, as well as elements of selective primary and secondary psychosocial prevention, has temporary effectiveness among high-risk group members. © Georg Thieme Verlag KG Stuttgart · New York.
Hannover, Fed. Rep. Germany , pendent vehicle- bridge interaction forces Vol. II, pp 379-398, 6 figs, 17 refs (In has been developed in the present The...79 STRUCTURAL SYSTEMS............. 44 Ducts......................... 80 Bridges ........................ 44 Building Components........... 81...Werkzeugmaschinen, Stuttgart T. Shimura, K. Kamijo Univ., Fed. Rep. Germany National Aerospace Lab., Tokyo, Japan Rept. No. BMFT-FB-HA-183-21, 100 pp Rept. No
Volk, Thomas; Engelhardt, Lars; Spies, Claudia; Steinfeldt, Thorsten; Kutter, Bernd; Heller, Axel; Werner, Christian; Heid, Florian; Bürkle, Hartmut; Koch, Thea; Vicent, Oliver; Geiger, Peter; Kessler, Paul; Wulf, Hinnerk
Regional anaesthesia generally is considered to be safe. However, reports of complications with different severities are also well known. The scientific working group of regional anaesthesia of the DGAI has founded a network in conjunction with the BDA. With the aid of a registry, we are now able to describe risk profiles and associations in case of a complication. Moreover, a benchmark has been implemented in order to continuously improve complication rates. (c) Georg Thieme Verlag KG Stuttgart-New York.
Reifferscheid, Florian; Stuhr, Markus; Kaiser, Guido; Freudenberg, Matthias; Kerner, Thoralf
Emergency medical care for injuries caused by acids and bases is challenging for rescue services. They have to deal with operational safety, detection of the toxic agent, emergency medical care of the patient and handling of the rescue mission. Because of the rareness of such situations experience and routine are largely missing. This article highlights some basic points for the therapy and provides support for such rescue missions. © Georg Thieme Verlag Stuttgart · New York.
Kohles, N; Schulz, T; Eßer, D
There are 2 different kinds of chronic otitis media: Otitis media chronica mesotympanalis and otitis media chronica epitympanalis (cholesteatoma). The incidence of chronic otitis media as reported in literature differs in a wide range. The incidence rates vary between 0.45 and 46%. Both, otitis media chronica mesotympanalis and cholesteatoma, lead to eardrum perforation due to lengthy and recurring inflammations. Furthermore, chronic otitis media is characterized by frequently recurring otorrhea and conductive hearing loss. Georg Thieme Verlag KG Stuttgart · New York.
Große, J; Menkouo, C; Grande, G
In a city district striving to sustainably develop into a healthy living environment for its residents, cooperation with locally active players as well as network management and the inclusion of citizens and local businesses as non-professional multipliers are particularly promising strategies for developing effective ways of promoting health and integrating them into existing structures in order to reach the target group. © Georg Thieme Verlag KG Stuttgart · New York.
Yang, Xinzhou; Tang, Chunping; Zhao, Ping; Shu, Guangwen; Mei, Zhinan
A new 2-(2-methylpropyl)butanedioic acid derivative, bletillin A ( 1), and a new bibenzyl, bletillin B ( 2), together with seventeen known compounds ( 3- 19), were isolated from the tubers of Bletilla ochracea Schltr. Their structures were established by detailed spectroscopic analyses. Phenanthrenes ( 12- 14) exhibited antibacterial activities against gram-positive bacteria Staphylococcus aureus, S. epidermidis, and Bacillus subtilis, with MIC values of 12.5-25 µg/mL. © Georg Thieme Verlag KG Stuttgart · New York.
Jah, H; Schalinksi, E; Fischer, J; Maier, J T; Schunck, K U; Hellmeyer, L
In 1909 the neurologist Dr. Hans Steinert was the first to describe the most common of all neural-muscular diseases: Mytotonic Dystrophy Curschmann Steinert. Up to today this disease is seldom published particularly in obstetrics. This is a case report of a 23-year-old patient. Following extensive interdisciplinary diagnostic a successful caesarian delivery of a healthy boy was performed in the 39(th) week of pregnancy without any complications. © Georg Thieme Verlag KG Stuttgart · New York.
Meltendorf, Gerhard; Meltendorf, Christian
The Law to Improve the Rights of Patients came into force with the promulgation in the German Federal Law Gazette on February 25, 2013. Thus administrations of medical institutions and doctors of all disciplines should acquaint themselves with the statutory regulations and their impact on the daily practice. The present article describes and explains the statutory regulations concerning patient education and treatment documentation. Georg Thieme Verlag KG Stuttgart · New York.
This guideline was created for the first time and is intended as a practical aid for the diagnosis and therapy of neuroendocrine tumors. The aim is to represent the current state of science, promote the recognition of the disease and improve the treatment of patients. The guideline was created under the leadership of the DGVS and with participation of neighbouring scientific societies. © Georg Thieme Verlag KG Stuttgart · New York.
Auer, Peter Gunther; Enck, Paul; Häuser, Winfried; Stengel, Andreas; Storr, Martin; Langhorst, Jost
The Association Psychosomatics in Gastroenterology of the DGVS aims to sharpen the profile of psychosomatic proportions in diagnostics, differential diagnostics and therapy of gastroenterological diseases, increasingly establish psychosomatic aspects in further education and clinical practice guidelines, deepen the cooperation with psychosomatic societies and strengthen the job satisfaction and mental health of gastroenterologists in Germany. © Georg Thieme Verlag KG Stuttgart · New York.
Jadulco, Raquel C; Koch, Michael; Van Wagoner, Ryan M; Pond, Christopher; Gideon, Osia G; Matainaho, Teatulohi; Piskaut, Pius; Barrows, Louis R
Two new triterpenoids were isolated from the leaves and twigs of Rhus taitensis. Their structures were elucidated by 1D and 2D NMR spectroscopic studies as 1,10,24,25,30-pentahydroxysqualene and dammar-20(22),24-diene-3 β,26,27-triol. Both compounds exhibited moderate antimycobacterial activities with an MIC of 45 µg/mL. © Georg Thieme Verlag KG Stuttgart · New York.
Interhospital transfers are an integral part of German health care system and a prerequisite to provide specialist investigation, management and best possible outcome for all patients irrespective of regional differences in medical care. In order to reduce transport associated risks to a minimum, adequate specialized transport teams and modern equipped transport vehicles are needed better and better adapted to regional and demographic changes. © Georg Thieme Verlag Stuttgart · New York.
Gonnert, Falk A; Meißner, Winfried
Metamizole is primarily used for severe perioperative pain, acute injury and colic, and cancer pain. For other acute/chronic forms of pain and high fever, it should only be used if unresponsive to other agents. Metamizole should not be used for middle and low pain. Oral application should be preferred. A contraindication for metamizole is leukopenia. Clinical signs for agranulocytosis are fever, tonsillitis and aphthous stomatitis. Georg Thieme Verlag KG Stuttgart · New York.
In the foreground of the avoidance of a CRPS as well as a recurrent CRPS, also pathophysiological considerations and use-possibilities of different drugs stand beside the observance of generally valid principles for treatment. Its consistent transposition cannot certainly prevent the CRPS in each case admittedly, the installment of the appearance or recurrence of a CRPS clearly lowers however. © Georg Thieme Verlag KG Stuttgart · New York.
We report the case of a 26-year-old woman with CRPS involving consecutively 3 extremities during 8 years. None of the treatments used was effective and each CRPS episode resulted in persistence and chronification of the disease. We suggest that this patient presents a specific subtype of the disease, called "chronic, refractory CRPS" which is extremely severe, disabling and resistant to treatment. © Georg Thieme Verlag KG Stuttgart · New York.
Reichl, H; Schütz, T; Gabl, M; Angermann, P; Russe, E; Wechselberger, G
By presenting 2 cases of successful hand replantation with similar trauma mechanism, level of amputation and ischaemia time of an 18-year-old female patient and a 48-year-old depressive male patient, the influence of age and sociomedical status on the postoperative outcome is discussed. DASH- (disabilities of the arm, shoulder and hand) score and Biometrics E-LINK power and sensitivity measurement were used to evaluate the outcomes. © Georg Thieme Verlag KG Stuttgart · New York.
Hahn, P; Dullweber, F; Unglaub, F; Spies, C K
Searching for relevant publications is becoming more difficult with the increasing number of scientific articles. Text mining as a specific form of computer-based data analysis may be helpful in this context. Highlighting relations between authors and finding relevant publications concerning a specific subject using text analysis programs are illustrated graphically by 2 performed examples. © Georg Thieme Verlag KG Stuttgart · New York.
Quantum Optoelectronics Technical Digest, 1993. Volume 8. Postconference Edition. Summaries of Papers Presented at the Quantum Optoelectronics Topical Meeting Held in Palm Springs, California on March 17-19, 1993.
Japan Wayne Knox AT&T Bell Laboratories Emilio Mendez IBM T J Watson Research Center Manfred PlIkuhn Universit~t Stuttgart, Germany John Ryan University...B. Khurgin, Shaozhong Li, Johns Hopkins Univ. Nonlinear optical fundamental-mode photons is demonstrated. (p. 6) properties of quantum wells, based on...OThAl Microcavity VCSELs, J. L. Jewell, Photonics Research 2:45 pm Inc.; A. Scherer, B. Van der Gaag, L. M. Schiavone , J. P. Harbison, QWC4 Semiconductor
Haas, Verena; Boschmann, Michael
Several studies provide evidence for the existence of a hypermetabolic state of biological origin in recently weight recovered patients with anorexia nervosa. It remains unclear if current nutritional rehabilitation strategies are consistent with the resulting high energy requirements. Further insight into specific pathophysiological characteristics of energetic efficiency in patients with anorexia nervosa will help us to provide evidence based nutritional guidance. Basic nutritional research in this field is urgently required. © Georg Thieme Verlag KG Stuttgart · New York.
Miljak, Tomislav; Zaar, Peter
Standard operating procedures (SOP) in hospital care have the potential to improve treatment quality and transparency. However, after arriving at the decision to generate a SOP for the own hospital or ward, the upcoming question is often, how to start?The present article tries to give some interdisciplinary guidance about reasonable structures and contents of SOPs that could be understood as a basic matrix for individual work. © Georg Thieme Verlag KG Stuttgart · New York.
Thiel, Aylin; Ehni, Franziska J F; Oddo, Silvia; Stirn, Aglaja
The Body Integrity Identity Disorder (BIID) is a fairly unknown and unexplored psychic illness. Very little cases underwent a psychotherapeutic treatment. We report on the two-and-a-half year psychotherapy with a 37 years old man, who wants an amputation of his two legs. Origin and meaning of the amputation desire were uncovered in psychotherapy. The psychodynamic oriented therapy with cognitive-behavioral elements can be used to develop further treatment approaches. © Georg Thieme Verlag KG Stuttgart · New York.
Schipper, Jörg; Kristin, Julia; Volpert, Simone; Klenzner, Thomas
We present a quality analysis of 10 patients with an individual treatment trial for a simultaneous or consecutive cochlea implantation after translabyrinthine removal of a neurinoma at the cerebellopontine angle. The results show that most of the patients benefit from the cochlea implantation after unilateral deafness. Through a careful surgical preparation technique at the inner ear canal and its surroundings the morphological and functional integrity of the neurovascular structures can be guaranteed. Georg Thieme Verlag KG Stuttgart · New York.
Widera, T; Baumgarten, E; Druckenmüller, A; Niehues, C
In Germany inpatient rehabilitation plays a major role for the treatment of children and adolescents with chronic health conditions. The German Pension Insurance carries out the rehabilitation of children and adolescents with high commitment. Paediatric rehabilitation enables children to go to kindergarten and school without interruption and participate in later professional life. The article specifies the basics of paediatric rehabilitation, describes the disease structure, defines the therapeutic care and explicates survey results. © Georg Thieme Verlag KG Stuttgart · New York.
Rusňák, Š; Maranová, Z; Kasl, Z; Hecová, L; Voigt, E; Raiskup, F
The aim of this work is to draw attention to possible injuries of the eye and the facial skeleton caused by firefighting sport. There was a group of 9 patients presented who were treated from 2006 to 2015 in the Department of Ophthalmology at the University Hospital in Pilsen and diagnosed with severe eyeball contusion after being hit by a jet of water and/or a water pipe. Three cases are presented in detail. Georg Thieme Verlag KG Stuttgart · New York.
Today's understanding of what health or well-being means often refers to certain ideals of activity and achievement. Lennart Nordenfelt's concept of health will be used to analyse and discuss this phenomenon. Furthermore, using the example of the ecclesiastical paper "God is a friend of life", we will explore if such conceptions of health also affect the teachings of the Christian churches. Georg Thieme Verlag KG Stuttgart, New York.
October 16, 1846 is regarded as the birth of anaesthesia at the Massachusetts General Hospital in Boston. However, was this really the first anaesthesia with sulphuric ether? In the priority dispute that started already in 1846 there were more participants: WTG Morton, CT Jackson and H Wells. Not involved was CW Long, who has already administered ether anaesthesia in 1842. He has published his results only 1849 and therefore he gained no glory. © Georg Thieme Verlag Stuttgart · New York.
Since the middle of the 19th century medical knowledge was increasing enormously. According to this differentiation medical specialisation was necessary and began at the Deutschen Ärztetag 1924. The recommendation for a specialist for anaesthesia was fulfilled with the introduction of the Facharzt für Anästhesie. The increasing knowledge stands in correlation to the specialization, but not with the slow installation of Anaesthesia as an independent speciality. © Georg Thieme Verlag Stuttgart · New York.
Allergies manifest differently in every patient: Even when the same allergen source is the causing agent, means of sensitization and complexity of symptoms can vary strongly across patients. This often complicates the prevention, diagnostics and therapy of food allergies - or even makes them impossible. This article gives an overview of the underlying immunological principles of food-allergies, as well as of the current therapeutic and diagnostic approaches. © Georg Thieme Verlag KG Stuttgart · New York.
Experimentalfahrzeug 8x DipL-fng. W. Slinkell Mercedes - Benz AG Stuttgart, Deutschland 3 Zumn Nachweis hoher Mobilittit wurde 1986 ein Experimentalfahrzeug Mx mit...propulsed by a 6 cylinder turbo charged Diesel engine from the passenger car series by Mercedes Benz and which is also equipped with an automatic...transmission by Mercedes Benz reaches 52 kilometers per hour when being used on the road and 4 km/h when swimming through water. II I i i DESIGN FEATURES I
Czaplik, Michael; Brokmann, Jörg; Rossaint, Rolf
Causes for reduced states of consciousness are diverse; it is often impossible to directly reveal the underlying agents. The following case report describes a young healthy patient who showed a temporary unconsciousness that first appeared seemingly without reason. Accidentally we hit a very uncommon cause for the prevailing carbon monoxide intoxication and were able to prevent further impairment of health status of both patient and environment. (c) Georg Thieme Verlag Stuttgart New York.
The catchwords "oversupply of physicians" and "mountain of hospital beds" may be considered to mark two points of culmination in German health policy discussion between 1960 and 1990. The political background and the practical implications of this discussion will be illustrated and appreciated taking into account both the distinct positions of the organised medical profession and junior staff. Georg Thieme Verlag KG Stuttgart, New York.
Jordan, Wolfgang; Adler, Lothar; Bleich, Stefan; von Einsiedel, Regina; Falkai, Peter; Grosskopf, Volker; Hauth, Iris; Steiner, Johann; Cohrs, Stefan
Increasing psychiatric disorder treatment need, increased work load, changes in the working hour regulations, the nation-wide shortage of physicians, efficiency principle and economisation can necessitate a reorganisation of medical services. The essential steps and instruments of process optimisation in medical services for a psychiatric clinic are elucidated and discussed in the context of demographic changes, generation change, and a new concept of values. © Georg Thieme Verlag KG Stuttgart · New York.
Annual Symposium on Blood. Stuttgart Germany: FK Schattauer Verlag, 1973; 91-94. Home M: Sickle cell anemia as a rheologic disease. Am J Med 1981; 70...AD___ AD-A222 948 CARDIOPULMONARY EFFECTS OF ACUTE STRESSFUL EXERCISE AT ALTITUDE OF INDIVIDUALS WITH SICKLE CELL TRAIT (SCT) FINAL REPORT Idelle M...Clawi’katiornj (U) Cardiopulmonlary Effects to Acute Stressful Exercise at Altitude of Individuals with - sickle Cell Trait (I1bAS) 12. PERSONAL. AUTHOR
Bürgi, Urs; Huber, Lars Christian
The auscultation of the lungs is - among anamnesis - the most important part in the assessment of patients presenting with pulmonary symptoms. The lung auscultation is reproducible, cost efficient and very helpful to distinguish between differential diagnoses, in particular in emergency situations. Detection and description of lung sounds requires experience and should be performed by strict adherence to the internationally accepted terminology. © Georg Thieme Verlag KG Stuttgart · New York.
Döcker, Dennis; Walther, Andreas
The use of muscle relaxants facilitates endotracheal intubation and ameliorates the conditions of surgery. But, their use should be controlled - otherwise there will be postoperative residual curarisation which can lead to patient discomfort up to severe medical complications. Therefore, an appropriate surveillance via objective neuromuscular monitoring is essential. This article gives a review of the basic principles of muscle relaxants, their clinical application and the surveillance of their effects and degradation. © Georg Thieme Verlag Stuttgart · New York.
Grossmann, Ole; Soccorso, Giampiero; Murthi, Govind
Hemorrhoids are uncommon in children. Third and fourth degree symptomatic hemorrhoids may be surgically excised. We describe the first experience of using LigaSure (Covidien, Mansfield, Massachusetts, United States) to perform hemorrhoidectomies in children. LigaSure hemorrhoidectomy has been well described in adults and is found to be superior in patient tolerance as compared with conventional hemorrhoidectomy. Georg Thieme Verlag KG Stuttgart · New York.
Grunwaldt, J.-D.; Hagelstein, M.; Rothe, J.
This preface of the proceedings volume of the 16th International Conference on X- ray Absorption Fine Structure (XAFS16) gives a glance on the five days of cutting-edge X-ray science which were held in Karlsruhe, Germany, August 23 - 28, 2015. In addition, several satellite meetings took place in Hamburg, Berlin and Stuttgart, a Sino-German workshop, three data analysis tutorials as well as special symposia on industrial catalysis and XFELs were held at the conference venue.
Robicsek, F; Watts, L T
The currently applied techniques recommended for the repair of pectus excavatum anomalies are discussed, set against a historical review of early clinical studies and surgical interventions. The issues of the future direction pectus excavatum surgery may take are analyzed in detail, with the reviewer expressing reservations in connection with the recent trend to closed repair and concern over the potential for serious complications associated with the application of this technique. © Georg Thieme Verlag KG Stuttgart · New York.
Sindermann, J R; Klotz, S; Rahbar, K; Hoffmeier, A; Drees, G
The German Disease Management Guideline "Chronic Heart Failure" intends to guide physicians working in the field of diagnosis and treatment of heart failure. The guideline provides a tool on the background of evidence based medicine. The following short review wants to give insights into the role of some surgical treatment options to improve heart failure, such as revascularization, ventricular reconstruction and aneurysmectomy, mitral valve reconstruction, ventricular assist devices and heart transplantation. (c) Georg Thieme Verlag KG Stuttgart-New York.
Passow, D; Bolz, M
This paper provides an overview of premenstrual dysphoric disorder (PMDD) and its clinical relevance in differentiation to premenstrual syndrome (PMS). Regarding recent research on epidemiology, aetiology, symptoms and therapy, PMDD is a discrete disorder and has a good prognosis in cases of appropriate diagnosis and therapy. The information provided in this review will help to better integrate PMDD into the psychiatric diagnostic process; options for diagnosis and treatment are also presented. © Georg Thieme Verlag KG Stuttgart · New York.
Illinois River Valley, Illinois; the Jonesboro and Stuttgart regions of Arkansas; Union and Alexander Counties in southern Illinois; Reelfoot Lake and Lake ...food habits of mammals in the vicinity of Reelfoot Lake Biological Station, III. Discussion of the mammals recorded from the area. J. Tennessee Acad...Yeager and Anderson (1944) found that fox squir- rels were present in all timbered areas of a leveed bottomland lake in Illinois. Lowery (1974) stated
Fenske, Wiebke; Christ-Crain, Mirjam
Hyponatremia is the most common electrolyte disorder in clinical practice with often severe and devastating complications. Hyponatremia itself as well as its inappropriate management is associated with pronounced morbidity and increased mortality risk. This manuscript presents some relevant novel findings in this field and discusses them in the context of the recently elaborated first European Guideline of hyponatremia. © Georg Thieme Verlag KG Stuttgart · New York.
Milkau, Malte; Sayk, Friedhelm
Thyroid storm and myxedema coma are the most severe clinical forms of thyroid dysfunction. While both hyper- and hypothyroidsm are common diseases, thyroid storm and myxedema coma are rare. Due to their unspecific signs and symptoms they are often difficult to diagnose. Both disorders are medical emergencies, which still show a significant mortality. The following article summarizes diagnostic tools and treatment options for these disorders. © Georg Thieme Verlag KG Stuttgart · New York.
Tripolar cups can be separated into constrained and unconstrained dual-mobility cups. The latter show better survival and revision rates. The main problem is the polyethylene wear. Therefore modern types of polyethylene are used in these cups. The indications for dual-mobility cups are recurrent dislocation and situations where the risk of dislocation is increased. Georg Thieme Verlag KG Stuttgart · New York.
Bonnet, U; Khalil-Boutros, Y
Parotitis is a fairly uncommon adverse drug reaction of psychopharmacological treatment. Here, we report on an acute bilateral parotitis, which was associated with titration of venlafaxine in a 20-year-old female suffering from a severe depressive episode. The parotitis recovered quickly with oral penicillin and was most likely caused by bacteria assumed to spread from oral flora into Stensen's duct as a complication of pronounced venlafaxine-induced xerostomia. © Georg Thieme Verlag KG Stuttgart · New York.
Picardi, Susanne; Lirk, Philipp; Blobner, Manfred; Schönherr, Marianne E; Hollmann, Markus W
Magnesium plays a key role in many cellular functions and there is growing interest in its role in perioperative medicine. While experimental studies provided promising results for several disease states, clinical trials mainly gave conflicting results. This review article summarizes current knowledge on the homeostasis of magnesium as well as on its proposed indications and recommendations in the clinical setting. © Georg Thieme Verlag Stuttgart · New York.
This paper aims to investigate the effects of sin-gle-parent families on the health of young peo-ple. Database is the 2010 HBSC survey as well as the 2002 and 2006 data for trend analysis. Findings show that there is a weak but significant effect of single-parent families on the health and health-behaviour of young people. There has been little change in the findings between 2002 and 2010. Georg Thieme Verlag KG Stuttgart · New York.
The Salomon-Neumann-Medal 2017 of the German Society for Social Medicine and Prevention (DGSMP) was awarded to Bernt-Peter Robra, Institute for Social Medicine and Health Economics (ISMG) of the Otto von Guericke University Magdeburg. The person and scientific merits of Manfred Pflanz are valued and topics of the masterplan2020-process are highlighted, that offer chances for developments in medicine and public health. © Georg Thieme Verlag KG Stuttgart · New York.
understanding crack nucleation (Laird et al at Pennsylvania, Fine et al at Northwestern, Neumann et al at Dusseldorf and Mughrabi et al at Stuttgart...hardened alloy in a project supported by the army. This work concentrated on the stability of precipitates under cyclic deformation ( Al -Ag, Al -Cu systems...and the strain-localization behavior of alloys containing shearable precipitates ( Al -Cu, e") and non-shearable precipitates ( Al -Cu, e’). Furthermore
W. Moench (Duisburg) H. Mughrabi (Erlangen) H. Neuhäuser (Braunschweig) J. Pollmann (Münster) H.-E. Schaefer (Stuttgart) J.-B. Suck (Chemnitz...et al . ) and also for the silicon vacancy Vacsi  the hyperfine interaction (hfi) constants e.g. are remarkably insensitive to the polytype and...TMs are tetrahedrally surrounded by four C ligands (TMyc in the notation of Wang et al . ) or by four Si (TMTgi) ligands. Computational. In our
Rütten, A; Frahsa, A; Rosenhäger, N; Wolff, A
The BIG approach aims at promoting physical activity and health among socially disadvantaged women. BIG has been developed and sustainably implemented in Erlangen/Bavaria. Subsequently, it has been transferred to other communities and states in Germany. Crucial factors for sustainability and transfer in BIG are (1) lifestyle and policy analysis, (2) assets approach, (3) empowerment of target group, (4) enabling of policy-makers and professionals. © Georg Thieme Verlag KG Stuttgart · New York.
Bischoff, Stephan C; Basrai, Maryam
Chronic kidney disease is associated with metabolic disorders. The nutrient requirement varies considerably and often it is not covered. This is why many patients experience severe deficiencies ("kidney disease wasting"), which limits their quality of life and prognosis. On the other hand sodium, potassium and phosphate must be limited. Nutritional therapy is a relevant part of the therapy. © Georg Thieme Verlag KG Stuttgart · New York.
Jordan, Wolfgang; Bleich, Stefan; Cohrs, Stefan; von Einsiedel, Regina; Falkai, Peter; Grosskopf, Volker; Hauth, Iris; Steiner, Johann; Adler, Lothar
Based on legal jurisdiction, knowledge of the psychiatric-psychotherapeutic field and insight into the necessity of a new allocation of responsibilities in the overall therapeutic service of a clinic, the core areas of medical activities are defined for the first time, innovative organisational approaches to the reorganisation of therapeutic service are presented and discussed against the background of qualified staff deficit, introduction of an OPS coding for inpatient psychiatry and economic constraints. © Georg Thieme Verlag KG Stuttgart · New York.
Vogelmeier, C; Buhl, R; Burghuber, O; Criée, C-P; Ewig, S; Godnic-Cvar, J; Hartl, S; Herth, F; Kardos, P; Kenn, K; Nowak, D; Rabe, K F; Studnicka, M; Watz, H; Welte, T; Windisch, W; Worth, H
This document is a revision of the guideline for diagnosis and treatment of COPD that replaces the version from 2007. A multitude of recent reports regarding risk factors, diagnosis, assessment, prevention and pharmacological as well as non-pharmacological treatment options made a major revision mandatory. The new guideline is based on the GOLD document taking into account specifics in Germany and Austria. © Georg Thieme Verlag KG Stuttgart · New York.
Tschöke, Stefan; Eisele, Frank; Steinert, Tilman
The case of a young woman with still ongoing incest and forced prostitution is presented. The criteria for a dissociative identity disorder (DID) were met. Due to persistent contact to the perpetrator she was repeatedly revictimized. Based on the model of trauma-related dissociation we discuss to what extent she was capable of self-determined decision making as well as therapeutic consequences resulting therefrom. © Georg Thieme Verlag KG Stuttgart · New York.
Chapter 1 – Introduction 1-1 Chapter 2 – Boundary Layer Transition and Laminar Flow Concepts 2-1 2.1 Transition Mechanisms and Transition Prediction 2...Laminar flow control LSTM Lehrstuhl für Strömungsmechanik der Universität Erlangen LWK Laminarwindkanal Stuttgart L2F Laser two-focus anemometer MMO...2.1 Transition mechanisms and transition prediction Modern transonic transport aircraft are characterized by a swept wing resulting in high cruise
Litschauer-Poursadrollah, M; Mayer, D E; Hemmer, W; Jarisch, R
Exposure to fresh water as well as to sea water can cause unpleasant consequences. The water of lakes or biotopes may be the reason for severe itching reactions on exposed skin, caused by cercariae. Exposure to seawater may lead to skin affections including itching or burning urticarial lesions as well as life threatening reactions. The causes for these reactions are especially species of jellyfish. (c) Georg Thieme Verlag KG Stuttgart. New York.
Following the end of World War II, regional associations for psychiatry and neurology were founded in the Soviet Occupation Zone. Using the association in Mecklenburg as an example and considering the way society developed in the German Democratic Republic (GDR), it will be shown whether and to what degree these were increasingly subject to state control. © Georg Thieme Verlag KG Stuttgart · New York.
tinuing theme for Vietcong propagandists who COMBAT CUISINE The cooks of the French Expeditionary Corps bottles, along with ammunition and medical sup...Vuono’s goal for the 1990s: an French Brigade in Stuttgart, Germany, offers a Army that is deployable, lethal, agile and versa- suitable model of such an...author offers several valid insights into the faulty planning and execution of the French stand at Dien Bien Phu in 1954 in Indochina, T 2400 ON 7 MAY
Darwiche, Kaid; Özkan, Filiz; Wolters, Celina; Eisenmann, Stephan
Endobronchial ultrasound (EBUS) has revolutionized the diagnosis of lung cancer over the last decade. This minimally invasive diagnostic method has also become increasingly important in the case of other diseases such as sarcoidosis, thereby helping to avoid unnecessary diagnostic interventions. This review article provides an update regarding EBUS and discusses current and future developments of this method. © Georg Thieme Verlag KG Stuttgart · New York.
Hecker, R M
When drinking water contaminations occur in installations belonging to a semiautonomous condominium community ( Wohnungseigentumsgemeinschaft ) and the water installation's final paths being owned by the various condominium owners, the German legal definition of the party responsible has a broad reach. Therefore, authorities should address the condominium community, the condominium owners and the community administrator ( WEG-Verwalter ). © Georg Thieme Verlag KG Stuttgart · New York.
Meißner, Winfried; Erlenwein, Joachim; Stamer, Ulrike
Organisational issues of acute pain management are as important as details of pharmacologic treatments or regional analgesia. Lothar Lachgas is a young intern in the department of anaesthesiology of a German hospital. This overview illuminates organisation of perioperative pain management based on his virtual experiences and questions: pain assessment and documentation, patient information and education, tasks of an Acute Pain Service. Georg Thieme Verlag KG Stuttgart · New York.
Smadi, Abla; Ciavatta, Maria Letizia; Bitam, Fatma; Carbone, Marianna; Villani, Guido; Gavagnin, Margherita
Chemical investigation of the rhizomes of the marine phanerogam Cymodocea nodosa resulted in the isolation of two new prenylated flavon-di- O -glycosides, cymodioside A ( 1 ) and B ( 2 ), along with known phenolic compounds 3 - 7 , some of which never reported from seagrasses to date. The structures of compounds 1 and 2 were established by extensive nuclear magnetic resonance analysis. In addition, the absolute configuration of 4-(2,5-dihydroxyhexyl) benzene-1,2-diol ( 7 ), which was not previously reported in the literature, has been now determined. Georg Thieme Verlag KG Stuttgart · New York.
Persistent pain despite previous surgery for de Quervain's disease might be due to an overlooked septum between the abductor pollicis longus tendon slips and the extensor pollicis brevis tendon, or an overlooked completely separate compartment for the extensor pollicis brevis tendon alone. In both of these instances, extension of the MP joint of the thumb against resistance elicits pain at the distal level of the first extensor compartment of the wrist. When this sign is positive, revisional surgery and decompression of the remaining septum or separate compartment is indicated. © Georg Thieme Verlag KG Stuttgart · New York.
Kruska, Patricia; Kappus, Stefan; Kerner, Thoralf
The prevalence of obesity has increased steadily in recent years. Obese people often suffer from diseases which acute decompensation requires a prompt prehospital therapy. The Emergency Medical Service will be confronted with difficulties in clinical diagnostic, therapy and especially with a delayed management of rescue and transport. It is most important to avoid prehospital depreciation in quality and time management. This article reviews the specific requirements of prehospital care of obese persons and discusses possible solutions to optimize the prehospital therapy. © Georg Thieme Verlag Stuttgart · New York.
Reifferscheid, Florian; Stuhr, Markus; Harding, Ulf; Schüler, Christine; Thoms, Jürgen; Püschel, Klaus; Kappus, Stefan
Major sport events require adequate expertise and experience concerning medical coverage and support. Medical and ambulance services need to cover both participants and spectators. Likewise, residents at the venue need to be provided for. Concepts have to include the possibility of major incidents related to the event. Using the example of the Hamburg Cyclassics, a road bicycle race and major event for professional and amateur cyclists, this article describes the medical coverage, number of patients, types of injuries and emergencies. Objectives regarding the planning of future events and essential medical coverage are consequently discussed. (c) Georg Thieme Verlag Stuttgart-New York.
Stappenbeck, J; Wendell, A; Thomasius, R
The Strengthening Families Program was developed in the USA and is regarded as an effective family-based prevention programme for youth. The evaluation of an adapted German version was carried out as a randomised-controlled multicentre trial. 292 families were recruited, 150 followed the intervention, and 142 received a minimal intervention. Acceptance from families and programme facilitators was high. Results about the effectiveness will be reported as soon as follow-up assessments are completed. © Georg Thieme Verlag KG Stuttgart · New York.
STS009-13-699 (28 Nov - 8 Dec 1983) --? Ulf Merbold, Spacelab 1 payload specialist, carries out one of the experiments using the gradient heating facility on the materials science double rack facility in the busy science module aboard the Earth-orbiting Space Shuttle Columbia. Representing the European Space Agency, Dr. Merbold comes from Max-Planck Institute in Stuttgart, the Federal Republic of Germany. He is a specialist in crystal lattice defects and low temperature physics. The photograph was made with a 35mm camera.
INTRODUCTION Riboswitches are naturally-occurring genetic regulatory elements found in the 5′ untranslated region of some mRNA. They provide a method...Industrial Genetics at the University of Stuttgart, Germany, respectively. The plasmid pSAL8.1 was kindly provided by Dr. Justin Gallivan from Emory...vol. 252: Ribozymes and siRNA Protocols, 2nd ed. Humana Press, Inc.; 2004, 145-164. (9) Suess, B., and Weigand, J.E. RNA Biology 2008, 5(1), 1-6
Zbýň, Š; Krššák, M; Memarsadeghi, M; Gholami, B; Haitel, A; Weber, M; Helbich, T H; Trattnig, S; Moser, E; Gruber, S
The presented evaluation of the relative uncertainty (δ'CCC) of the (choline + creatine)/citrate (CC/C) ratios can provide objective information about the quality and diagnostic value of prostate MR spectroscopic imaging data. This information can be combined with the numeric values of CC/C ratios and provides metabolic-quality maps enabling accurate cancer detection and user-independent data evaluation. In addition, the prostate areas suffering most from the low precision of CC/C ratios (e. g., prostate base) were identified. © Georg Thieme Verlag KG Stuttgart · New York.
Kaiser, F; Engelhardt, M; Rawluk, J; Mertelsmann, R; Passlick, B; Wäsch, R
Lung cancer occurs with a median age of 69 years. The main cause is cigarette smoking. For both genders lung cancer is the third-most frequent tumor in Germany. While in an operable tumor stage 30-80% of the patients can reach long-term survival, the prognosis in the metastasised stage is unfavourable with a 5-year overall survival rate of 6% for small cell lung cancer (SCLC) and 18% for non-small cell lung cancer (NSCLC). Lung cancer is subject of intense research to improve the outcome. This article gives an overview of current treatment options. © Georg Thieme Verlag KG Stuttgart · New York.
Fluid inclusions trapped within crystals either during growth or at a later time provide many clues to the histories of rocks and ores. Estimates of fluid-inclusion homogenization temperature and density can be obtained using a petrographic microscope with thin sections, and they can be refined using heating and freezing stages. Fluid inclusion studies, used in conjunction with paragenetic studies, can provide direct data on the time and space variations of parameters such as temperature, pressure, density, and composition of fluids in geologic environments. Changes in these parameters directly affect the fugacity, composition, and pH of fluids, thus directly influencing localization of ore metals. ?? 1977 Ferdinand Enke Verlag Stuttgart.
Reimann, B; Böhme, C
Poverty represents a considerable health risk. As social- and health-related disadvantages are spatially concentrated, municipalities must take up the task of forging a stronger link between urban district development and health promotion than has thus far been the case. Moreover, they must put health promotion as part of urban district development as an item on the agenda. The present contribution illustrates in which ways health promotion in disadvantaged urban districts and its scientific monitoring and evaluation can be successful. © Georg Thieme Verlag KG Stuttgart · New York.
Süß, W; Nickel, S; Wolf, K; Trojan, A
In 2005 the local health authority Hamburg-Eimsbüttel developed a prevention programme for the disadvantaged quarter "Lenzsiedlung" which has been implemented by the stakeholders committee "Round Table Lenzgesund" and other partners led by the health authority. The Department of Medical Sociology and Health Economics of the University Medical Centre had taken on the accompanying analysis and long-term evaluation with a mixture of qualitative and quantitative methods for health reporting and evaluation and a new instrument for measuring capacity building in the quarter (KEQ). © Georg Thieme Verlag KG Stuttgart · New York.
The beginnings of modern western medicine reach to about 1800 when under the liberating influence of French Revolution observation of diseases was started to follow more scientifically justified criteria. At that time speculative doctrines prevailed, e. g. those set up natural philosopher Schelling. In this context Internist Friedrich Theodor von Frerichs at Berlin Charité University Hospital gained great merits because of his struggle for a scientifically-based experimental clinical medicine. This is demonstrated nicely in a recently found autograph document. © Georg Thieme Verlag KG Stuttgart · New York.
Riedel-Heller, Steffi; Gühne, Uta
Investment in prevention is a major public health requirement. Mental disorders are common and are associated with severe consequences. They are a major target for prevention. Based on vulnerabilitiy-stress-models the theoretical background for prevention in mental disorders is outlined. Effective strategies for children, adolescents, adults and individuals in old age do exist. Results regarding the prevention of depres-sion and psychoses are outlined and risk groups which require current actions are determined. Current activities towards a national prevention strategy in Germany are discussed. © Georg Thieme Verlag KG Stuttgart · New York.
activ n e pronte . pwindkanal", Dissertation, Universittit Stuttgart, 1998. A mass spectrometer probe can be used with low [A.9] Auweter-Kurtz, M., Laure...obtained ffrom experiments at a plasma state with a mass flowFig. B2.28: RtooOISobandfrom dintensities in a 3D -view rate of 2 g/s air and an ambient...spectrometer work is based on the estimations either in solid food stuffs or organic chopped-light (AC) principle which is illustrated in materials ( e.g
Chiu, Philip W Y; Inoue, Haruhiro; Rösch, Thomas
Recent advances in submucosal endoscopy have unlocked a new horizon for potential development in diagnostic and therapeutic endoscopy. Increasing evidence has demonstrated that peroral endoscopic myotomy (POEM) is not only clinically feasible and safe, but also has excellent results in symptomatic relief of achalasia. The success of submucosal endoscopy in performance of tumor resection has confirmed the potential of this new area in diagnostic and therapeutic endoscopy. This article reviews the current applications and evidence, from POEM to peroral endoscopic tunnel resection (POET), while exploring the possible future clinical applications in this field. © Georg Thieme Verlag KG Stuttgart · New York.
Hack, Juliana; Bliemel, Christopher; Ruchholtz, Steffen; Bücking, Benjamin
Hip fractures are among the most common fractures in elderly people. The annual number of femoral fractures is even expected to increase because of an aging society. Due to the high number of comorbidities, there are special challenges in treating geriatric hip fracture patients, which require a multidisciplinary management. This includes surgical treatment allowing full weight bearing in the immediate postoperative period, osteoporosis treatment and falls prevention as well as an early ortho-geriatric rehabilitation program. © Georg Thieme Verlag Stuttgart · New York.
Clemm von Hohenberg, Christian; Dreßing, Harald
We report the case of a 48-year-old female whom we examined for legal culpability. The proband was taking the dopamine agonist pramipexole as a treatment for Parkinson's disease. In temporal association, she had committed numerous shoplifting offences.While pathological gambling, excessive shopping and hypersexuality have often been described as adverse effects of dopamine agonists, there are only few reports about impulsive stealing in this context.We discuss the synergy of the pharmacological effects with familial, biographic and social factors, suggesting a bio-psycho-social etiology. © Georg Thieme Verlag KG Stuttgart · New York.
Bernheim, Dorothee; Becker, Mathias; Gander, Manuela; Lischke, Alexander; Mentel, Renate; Buchheim, Anna; Freyberger, Harald J
Objective Investigate influence and change of self-directedness (SD) in Dialectical-Behavior Therapy (DBT) for 26 female outpatients with borderline personality disorder (BPS). Method Variance analyses are used to evaluate psychopathology and interpersonal problems in 2 subgroups (low vs. high SD) with questionnaires at 3 measuring times over the period of 1 year. Results Low SD was associated with higher psychopathology, more interpersonal problems and lower symptomreduction. Over time of intervention the SD of all patients improved significantly. Conclusion DBT strengthens the SD of patients with BPD. A screening of SD before intervention, and systematic support should be considered. © Georg Thieme Verlag KG Stuttgart · New York.
Sander, Lasse; Ebert, David Daniel; Baumeister, Harald
Guided Internet- and mobile-based interventions (IMIs) are an effective and scientifically sound treatment option for depression. Meta-analyses revealed effect sizes comparable to those found for face-to-face treatment as well as pharmacotherapy. Today, most IMIs are based on cognitive behavioral therapy (CBT). While IMIs are well established in healthcare systems of many countries worldwide, Germany is still lagging behind. However, there are an increasing number of model projects trying to implement IMIs into routine healthcare for depression in Germany. Both, service providers and recipients would benefit from transparent quality assurance and data safety guidelines. © Georg Thieme Verlag KG Stuttgart · New York.
Schär, Ralph T; Hewer, Ekkehard; Ulrich, Christian T
A 36-year-old man was diagnosed with Langerhans cell histiocytosis (LCH) of the cervical spine with a unifocal expansive osteolytic lesion of C4. The surgical management with a 2-year follow-up and a review of the literature on LCH of the cervical spine are presented. Although a rare condition, LCH is an important differential diagnosis of any osteolytic lesion in the cervical spine with localized pain in a young adult patient. Review of the literature suggests a higher prevalence of LCH lesions affecting the cervical spine as compared with the thoracic or lumbar spine than historically reported. Georg Thieme Verlag KG Stuttgart · New York.
Waidmann, Oliver; Pelzer, Uwe; Boeck, Stefan; Waldschmidt, Dirk-Thomas
Pancreatic cancer is one of the most lethal cancer diseases. For years, gemcitabine has been the standard of care and the only therapeutic option in patients with metastatic pancreatic cancer. Within the last years, new combination therapies have been established for first-line treatment, which significantly improve overall survival in comparison to gemcitabine monotherapy. Furthermore, new second-line therapies have been identified, which significantly improve overall survival. The current manuscript summarizes briefly standard of care first- and second-line chemotherapies and discusses possible treatment sequences. © Georg Thieme Verlag KG Stuttgart · New York.
Sivasothy, Yasodha; Ibrahim, Halijah; Paliany, Audra Shaleena; Alias, Siti Aisyah; Md Nor, Nurur Raudzah; Awang, Khalijah
The rhizomes of Alpinia pahangensis yielded a new bis-labdanic diterpene for which the name pahangensin C (1) was proposed along with twelve known analogues (2-13). The structure of 1 was elucidated via spectroscopic methods including 1D and 2D NMR techniques and LCMS-IT-TOF analysis. Compounds 2 and 12 were isolated for the first time from the genus Alpinia. This is the second occurrence of compounds 2 and 12 in the Zingiberaceae family. Selected analogues exhibited moderate to strong inhibitory activity against Staphylococcus aureus and Bacillus cereus. Georg Thieme Verlag KG Stuttgart · New York.
Forty years ago an expert-commission submitted a report on the deplorable state of German psychiatric care, called the "Psychiatrie-Enquete" to the Bundestag, the German parliament. The Report initiated a substantial change of Psychiatric services in the country. Inhuman treatment and living conditions were superseded. Mental hospitals were not completely abolished. But they lost their importance in favour of decentralized psychiatric services including departments at general hospitals, day hospitals and outpatient services. Custodial care was largely successfully developed into therapeutic and rehabilitative care. This article attempts a mildly critical evaluation of the Enquête 40 years after. © Georg Thieme Verlag KG Stuttgart · New York.
In 1970 two new species within the so-called subgenus "Streptobacterium" Orla-Jensen of the genus Lactobacillus were described (Reuter, 1970). They were named L. alimentarius with the type strain "R 13" (DSM 20249) and L. farciminis with the type strain "Rv 4na" (DSM 20184). Since these two names have so far not been included in the "Approved Lists of Bacterial Names" (Skerman et al., 1980) they are revived for the same organisms with the same type strains. Copyright © 1983 Gustav Fischer Verlag, Stuttgart/New York. Published by Elsevier GmbH.. All rights reserved.
Chrubasik, C; Himmelberger, D; Kohlmann, T; Chrubasik, S
The aim of this study was to prepare according to standardised criteria a German version of the validated short instrument for the quality of life in patients suffering from hypertension. This instrument is appropriate for clinical trials investigating the effectiveness of antihypertensive treatments. But also in the daily routine this instrument enables one to identify any impairment of life quality due to antihypertensive treatment as early as possible, especially sexual dysfunction, and to react appropriately with treatment adaptations. © Georg Thieme Verlag KG Stuttgart · New York.
Hölscher, U M
The effectiveness of the risk management systems established by medical device manufacturers and health-care facilities is clearly mitigated by European and national legal provisions. Laws, regulations and authorities prevent the systematic exchange of much safety-relevant information. The obligation to report adverse events is suspended for many relevant risks associated with medical device use. Reporting into the vigilance system is of little avail for users. Reporting even may endanger the information provider. The federal fragmentation of the German vigilance system poses a risk for patients. Risk management in health-care facilities without risk policy is dangerously incomplete. © Georg Thieme Verlag KG Stuttgart · New York.
Pawils, S; Busche, W; Schwinn, A; Fillinger, U; Koch, U
The "parental folder" is meant as a primary prevention programme for children starting at birth with the aim to give access to relevant health knowledge to all parents and to strengthen the parental competence in doctor-parent communication. In a sample of N=1,634 families the effects of the folder were examined in a randomized controlled study in the federal states Rhineland-Palatinate and Saxony. In addition N=103 experts were asked for their valuation of the folder. © Georg Thieme Verlag KG Stuttgart · New York.
Lambert, Martin; Härter, Martin; Arnold, Detlef; Dirmaier, Jörg; Tlach, Lisa; Liebherz, Sarah; Sänger, Sylvia; Karow, Anne; Brandes, Andreas; Sielaff, Gyöngyver; Bock, Thomas
Evidence shows that poor mental health literacy and stigmatization have negative consequences on mental health. However, studies on interventions to improve both are often heterogenic in methodology and results. The psychenet-campaign in Hamburg was developed and implemented in collaboration with patients and relatives and comprised multidimensional interventions focusing on education and contact to patients. The main goals were the improvement of mental health literacy and destigmatization and the long-term implementation within Hamburg's mental health care system. © Georg Thieme Verlag KG Stuttgart · New York.
Schmeling-Kludas, Christoph; Koch-Gromus, Uwe
In spite of its plenitude, the scientific works of the important German psychologist Ernst August Dölle (1898-1972) are little adapted till today, mostly they are being reduced to his studies about dichotomy and duplicity. But based on his diaries of the year 1968, the authors can verify without doubt, that Dölle far ahead of his time, carried on research about sustainability and diversity. He was the first scientist worldwide to connect these two concepts. Georg Thieme Verlag KG Stuttgart · New York.
Breidert, M; Offensperger, S; Blum, H E; Fischer, R
Thyrotoxicosis may significantly alter hepatic function and is associated with autoimmune disorders of the liver. We report the case of a thyrotoxic patient with Graves' disease and histologically established cholestatic hepatitis. Medical treatment of hyperthyroidism normalized liver function tests. In patients with elevated liver function parameters and jaundice of unknown origin, thyroid function should generally be tested. Moreover, medical treatment of hyperthyroidism with thyrostatics may cause severe hepatitis whereas untreated hyperthyroid patients are at risk of developing chronic liver failure. © Georg Thieme Verlag KG Stuttgart · New York.
Baur, X; Woitowitz, H-J
Lung cancer is one of the most frequently encountered cancer types. According to the latest WHO data, about 10 % of this disease are due to occupational exposure to cancerogens. Asbestos is still the number one carcinogen. Further frequent causes include quarz and ionizing radiation (uranium mining). Probable causes of the disease can be identified only with the help of detailed occupational history taken by a medical specialist and qualified exposure assessment. Without clarifying the cause of the disease, there is neither a correct insurance procedure nor compensation for the victim, and furthermore, required preventive measures cannot be initiated. © Georg Thieme Verlag KG Stuttgart · New York.
The Bernoullis were one of the most distinguished families in the history of science. It was Daniel Bernoulli who applied mathematical physics to medicine to further his understanding of physiological mechanisms that have an impact even in today's high-end medicine. His masterwork was the analysis of fluid dynamics, which resulted in Bernoulli's law. Most important for cardiac surgery, it describes how a centrifugal pump works within an extracorporeal circulation, lays the basis for measuring a gradient over a stenotic heart valve, and explains how to measure the transit time flow within a bypass graft. Georg Thieme Verlag KG Stuttgart · New York.
Dederichs, F; Knüdeler, S; Nolte, W; Iesalnieks, I
Rectal stricture is a serious although infrequent complication of transanal endoscopic microsurgery (TEM). In some cases, these strictures may be refractory to treatment by endoscopic balloon dilatation. Biodegradable stents might improve the outcome by providing an extended period of dilatation. Moreover, these stents can remain in place without the need to remove them. In the presented case, a biodegradable polidioxanone stent originally developed to treat benign oesophageal stenoses was used to treat a patient suffering from rectal stricture following a TEM. © Georg Thieme Verlag KG Stuttgart · New York.
Gühne, Uta; Becker, Thomas; Riedel-Heller, Steffi
The Psychiatry Enquête turned 40 years old last year. The S3 guideline "Psychosocial therapies for severe mental illness" is considered to be the last milestone of the reform to date. This paper highlights new impulses resulting from the S3 guideline for psychiatric care and provides an outlook on the update, expected in 2017. Many of the interventions reported in the S3 guideline are now supported by a broader evidence base. © Georg Thieme Verlag KG Stuttgart · New York.
Schiffer, G; Sayar, A; Thelen, U
The deltoideopectoral approach is established as the gold standard in the surgical treatment of proximal humeral fractures. As an alternative, we demonstrate the extended deltoid approach with an intraoperative video. A direct lateral incision is performed and the anterior parts of the axillary nerve are identified and preserved. In our experience, this approach allows improved visualisation of the greater tuberosity and easier positioning of locking plates. Clinically relevant neurological injuries cannot be seen in our patients or in the literature. Georg Thieme Verlag KG Stuttgart · New York.
Neubauer, Bernd A; Lemke, Johannes R
It is estimated that in humans approximately 50% of all 22500 genes are needed for the development and maintenance of the nervous system. The introduction of high-throughput technology in genetic analysis has therefore major implications, not only for the investigation of specific disease entities but also for the diagnostic workup of single individuals with neurologic disorders of genetic origin. A short primer for clinicians is presented, addressing aspects of current developments in medical genomics. Significant findings of the last years are exemplified in an educational manner to provide a basic understanding of disease mechanisms that were unraveled by recent genomic analysis. Georg Thieme Verlag KG Stuttgart · New York.
Mahringer, Anne; Ardjomand-Woelkart, Karin; Bauer, Rudolf; Fricker, Gert; Efferth, Thomas
The blood-brain barrier prevents the passage of toxic compounds from blood circulation into brain tissue. Unfortunately, drugs for the treatment of neurodegenerative diseases, brain tumors, and other diseases also do not cross the blood-brain barrier. In the present investigation, we used isolated porcine brain capillary endothelial cells and a flow cytometric calcein-AM assay to analyze inhibition of P-glycoprotein, a major constituent of the blood-brain barrier. We tested 8 alkamides isolated from Echinacea angustifolia and found that four of them inhibited P-glycoprotein-mediated calcein transport in porcine brain capillary endothelial cells. Georg Thieme Verlag KG Stuttgart · New York.
Porz, R; Zimmermann, H; Exadaktylos, A K
Accidents can lead to difficult boundary situations. Such situations often take place in the emergency units. The medical team thus often and inevitably faces professional uncertainty in their decision-making. It is essential to communicate these uncertainties within the medical team, instead of downplaying or overriding existential hurdles in decision-making. Acknowledging uncertainties might lead to alert and prudent decisions. Thus uncertainty can have ethical value in treatment or withdrawal of treatment. It does not need to be covered in evidence-based arguments, especially as some singular situations of individual tragedies cannot be grasped in terms of evidence-based medicine. © Georg Thieme Verlag KG Stuttgart · New York.
Gao, Ting; Sun, Zhiying; Yao, Hui; Song, Jingyuan; Zhu, Yingjie; Ma, Xinye; Chen, Shilin
In this study, we tested the applicability of the core DNA barcode MATK for identifying species within the Fabaceae family. Based on an evaluation of genetic variation, DNA barcoding gaps, and species discrimination power, MATK is a useful barcode for Fabaceae species. Of 1355 plant samples collected from 1079 species belonging to 409 diverse genera, MATK precisely identified approximately 80 % and 96 % of them at the species and genus levels, respectively. Therefore, our research indicates that the MATK region is a valuable marker for plant species within Fabaceae. © Georg Thieme Verlag KG Stuttgart · New York.
Müller, Christoph; Reina, Guido; Burch, Michael; Weiskopf, Daniel
The University of Stuttgart's software engineering major complements the traditional computer science major with more practice-oriented education. Two-semester software projects in various application areas offered by the university's different computer science institutes are a successful building block in the curriculum. With this realistic, complex project setting, students experience the practice of software engineering, including software development processes, technologies, and soft skills. In particular, visualization-based projects are popular with students. Such projects offer them the opportunity to gain profound knowledge that would hardly be possible with only regular lectures and homework assignments.
Heim, N; Faron, A; Wiedemeyer, V; Teschke, M; Reich, R H; Martini, M
Since introduction of the first fillers in the 1980s a multitude of substances has been developed and approved for facial contour augmentation and correction of skin defects. Here we present the interesting case of a patient who presented to us with a delayed infection 6 weeks after augmentation of the upper lip with a hyaluronic acid. We observed full convalescence after operative and high-dose antibiotic treatment of the abscesses. Generally speaking, complications after augmentation with resorbable fillers are rare. However, complications might occur even within unexpected time periods and therefore need our special attention. © Georg Thieme Verlag KG Stuttgart · New York.
Freitag, T; Langer, S
Currently, interventional (angiographically-guided) therapies have become more and more important in cardiovascular medicine. Hybrid procedures in hybrid operating rooms (ORs) have now become major topics at national and international meetings. A few hospitals have already implemented the project "hybrid OR", in some institutions the system is still in the planning stage. The aim of our article is to present the hospital management point of view, and thus, to focus on the economic and logistic issues from planning through to implementation. Georg Thieme Verlag KG Stuttgart · New York.
The statement of the Federal Association of Physicians of Public Health Services provides recommendations concerning tuberculosis screening of refugees and asylum seekers on arrival specific to different groups of persons (adults, children, pregnant women, unaccompanied minors), taking into account the legal background and the current recommendations of the Robert Koch Institute as well as of the German Society for Pediatric Infectiology. In addition, recommendations are given to ensure treatment success in refugees and asylum seekers with tuberculosis, to carry out contact investigations and for preventive treatment of latent tuberculosis infection among refugees and asylum seekers. © Georg Thieme Verlag KG Stuttgart · New York.
Lailach, S; Zahnert, T
The present article about the basics of ear surgery is a short overview of current indications, the required diagnostics and surgical procedures of common otologic diseases. In addition to plastic and reconstructive surgery of the auricle, principles of surgery of the external auditory canal, basics of middle ear surgery and the tumor surgery of the temporal bone are shown. Additionally, aspects of the surgical hearing rehabilitation (excluding implantable hearing systems) are presented considering current study results. Georg Thieme Verlag KG Stuttgart · New York.
Wallesch, C W; Fries, W; Marx, P; du Mesnil de Rochemont, R; Roschmann, R; Schmidt, R; Schwerdtfeger, K; Tegenthoff, M; Widder, B
In 2005, the "Deutsche Gesellschaft für Neurowissenschaftliche Begutachtung" (German Society for Neuroscientific Legal Evaluation) together with other Societies published a guideline for the legal evaluation of patients with closed head injuries. Meanwhile, not only scientific progress in imaging techniques but also in other fields such as neuropsychology has necessitated a revision, which is presented here. In the mean time, the handling of guidelines has been systematised in Germany so that a registration with the Cooperation of German Medical Learned Societies is applied for and publication in the German Guideline Registry is expected. © Georg Thieme Verlag KG Stuttgart · New York.
Nyhan, William L; Gangoiti, Jon A
Objective Orotic aciduria and deficiency of uridine monophosphate synthetase have been observed in a patient, studied over 10 years, who had no megaloblastic anemia. Excretion of orotic acid and orotidine were 8.24 and 0.52 mmol/mol of creatinine. The ratio of 15.85 differed appreciably from that of 6 patients reported with no megaloblastic anemia. Methods The analysis of orotidine by gas chromotography mass spectrometry was conducted. Conclusion Patients with orotic aciduria with and without megaloblastic anemia cannot be distinguished by ratio of orotic acid to orotidine. Georg Thieme Verlag KG Stuttgart · New York.
Jenssen, C; Pietsch, C; Gottschalk, U; Barreiros, A P; Teufel, A; Cui, X W; Dietrich, C F
In patients with diabetes mellitus, abdominal ultrasonography is the appropriate diagnostic technique to detect and to follow-up secondary and accompanying diseases of the liver, the kidneys, the pancreas, the gastrointestinal tract and of abdominal vessels. Moreover, pancreatic and hepatic diseases may be realized which are of etiological importance for diabetes mellitus. Based on a systematic survey of the published literature, this review in 3 parts will describe the value of abdominal ultrasonography in patients with diabetes mellitus. Part 1 deals with the diagnostic relevance and particular findings of ultrasonographic methods in hepatic manifestations and complications of diabetes mellitus. © Georg Thieme Verlag KG Stuttgart · New York.
Wang, Xiao-Yang; Chen, Xiao-Li; Tang, Hai-Feng; Gao, Hui; Tian, Xiang-Rong; Zhang, Ping-Hu
Two new oleanane-type triterpenoid saponins, 1 and 2, and a new natural product, 3, together with five known saponins, 4- 8, were isolated from the rhizomes of ANEMONE TAIPAIENSIS. Their structures were elucidated by extensive spectroscopic analysis and chemical evidences. Six saponins, 1, 2, 4- 7, which possessed a free carboxylic group at C-28, exhibited significant cytotoxicity against human leukemia HL-60 cells and human hepatocellular carcinoma Hep-G2 cells with IC (50) values in the range of 1.31-10.12 µM. © Georg Thieme Verlag KG Stuttgart · New York.
Aboukhoudir, Falah; Pansieri, Michel; Rekik, Sofiene
Churg-Strauss syndrome is a necrotizing systemic vasculitis characterized by extravascular granulomas and eosinophilic infiltrates of small vessels. Although cardiac complications are considered to be relatively common, no case of constrictive calcified pericarditis has ever been previously described in this setting. In this report, we present the case of a 46-year-old man with Churg-Strauss syndrome, in whom we were able to document the development of symptomatic calcific constrictive pericarditis during a 10-year period despite long-term corticosteroid therapy. Georg Thieme Verlag KG Stuttgart · New York.
von Rüden, Christian; Bühren, Volker; Perl, Mario
The adequate treatment of severely injured patients is challenging and can only be successfully executed when it starts at the accident site and is continued in all treatment phases including the early rehabilitation phase. Treatment should be performed by an interdisciplinary team guided by a trauma surgeon in order to adequately manage the severe injuries some of which are life-threatening. Treatment of polytrauma patients is a key task of certified trauma centers and must follow standardized guidelines. For a successful therapy of severely injured patients lifetime training at regular intervals in well-established polytrauma concepts is a mandatory requirement. Georg Thieme Verlag KG Stuttgart · New York.
Eckert, K; Lange, M
Exercise programs do not belong to standard treatment within disease management programmes for diabetes mellitus type 2, up to now. For these reason the effects of a 10-week behaviour-oriented exercise programme have been evaluated focusing on change in activity behaviour and health-related qualitiy of life. 202 patients took part in the investigation. There were significant inbetween group differences in some aspects of the outcome parameters. The study presents useful information on how to modify existing DMPs successfully for improving patient treatment. © Georg Thieme Verlag KG Stuttgart · New York.
Gastroesophageal reflux disease (GERD) is highly prevalent in the Western world. Patients with GERD have a 10 fold increased risk to develop a Barrett's esophagus. Patients with Barrett's esophagus have a higher risk for an esophageal adenocarcinoma. Men have more severe reflux with a higher grade of inflammation and acid reflux. This seems to be the reason why men develop a Barrett's esophagus more frequently--the risk is approximately 2 to 3 fold and the risk for an esophageal adenocarcinoma is even 3 to 6 times higher. © Georg Thieme Verlag KG Stuttgart · New York.
Gastroesophageal reflux disease (GERD) is highly prevalent in the Western world. Patients with GERD have a 10-fold increased risk to develop a Barrett's esophagus. Patients with Barrett's esophagus have a higher risk for an esophageal adenocarcinoma. Men have more severe reflux with a higher grade of inflammation and acid reflux. This seems to be the reason why men develop a Barrett's esophagus more frequently - the risk is approximately 2-3-fold and the risk for an esophageal adenocarcinoma is even 3-6 times higher. © Georg Thieme Verlag KG Stuttgart · New York.
Evers, Bettina; Muth, Claus-Martin; Georgieff, Michael; Dinse-Lambracht, Alexander
Emergency medical service is called by a 54-year-old man bitten by his rattlesnake. Upon initial survey we find the patient in a cardiopulmonary stable condition. He has bite marks and pain on his rapidly swelling middle finger of his right hand. Our initial treatment is immobilization of the patient. The snake raiser has already called the poison control center in Munich. By the help of this institution we bring him to a hospital having the right antivenom on hand. © Georg Thieme Verlag Stuttgart · New York.
Zech, Nina; Kieninger, Martin; Seemann, Milena; Künzig, Holger; Bele, Sylvia; Dietl, Alexander
We report the case of a patient who suffered a serious subarachnoid hemorrhage with a cardialaffection and development of an inverted Tako-Tsubo-cardiomyopathy. To avoid apparent cerebral ischemia due to severe cerebral vasospasm after exhaustion of conservative therapeutic options a temporarily endovascular therapy with continuous intra-arterial application of Nimodipine was necessary. In the overall protracted and complicated course the special challenge were the therapeutic efforts to avoid apparent cerebral ischemia in context to the significant cardial affection. © Georg Thieme Verlag Stuttgart · New York.
Papenfuß, Tim; Roch, Carmen
74% of all hospitals had vacant positions in 2011, also departments of anaesthesiology and intensive care medicine. More than 50% of these departments work with locums. There are couple of reasons for the shortage of physicians. The consequences in anaesthesiology and intensive care medicine can result in qualitative and financial loss. To solve the shortage of physicians one has to solve the reasons. Main reasons are increasing feminization of medical profession and part-time-work, work-life-balance and a poor specialised education. © Georg Thieme Verlag Stuttgart · New York.
Fliniaux, Ophélie; Roscher, Albrecht; Cailleu, Dominique; Mesnard, François
Cell suspensions initiated from Duboisia myoporoides -a shrub belonging to the Solanaceae family and being a rich source of tropane alkaloids-previously showed their ability to glycosylate scopoletin into scopolin, which represent coumarins showing health benefits. To investigate the time course of this glycosylation reaction, an in vivo NMR approach was developed using a perfusion system in an 8-mm NMR tube and 1 H NMR with 1D and 2D (TOCSY and NOESY) experiments. The time course of metabolic changes could therefore be followed without any labeling. Georg Thieme Verlag KG Stuttgart · New York.
Aigner, Clemens; Slama, Alexis; Valdivia, Daniel
Extracorporeal membrane oxygenation (ECMO) has become a routine method in thoracic surgery. Recent developments in lung transplantation have led to its widespread acceptance. Firstly, ECMO is increasingly being used to bridge patients to transplantation. The best results in this setting have been described with "awake ECMO". Secondly, ECMO has replaced cardio-pulmonary bypass as the intraoperative standard device in most centres and is used for treatment and prevention of primary graft dysfunction. Refinements of the devices in use and the cannula design allow an individualised approach tailored to the respiratory and haemodynamic situation of the patients and the anticipated duration of ECMO support. Georg Thieme Verlag KG Stuttgart · New York.
Brunner, Stefan; Rizas, Konstantinos; Hamm, Wolfgang; Mehr, Michael; Lackermair, Korbinian
It is known that physical exercise may increase platelet activity. However, the effect of exercise on platelet reactivity in patients on dual antiplatelet therapy has not been investigated yet. In our study, 21 patients with coronary artery disease on dual antiplatelet therapy and 10 controls were enrolled. We performed an exercise test using a cycle ergometer and determined the adenosine diphosphate-induced platelet reactivity before and immediately after exercise testing. Additionally, we analysed maximal exercise capacity and an electrocardiogram. Further, we assessed chromogranin A and P-selectin levels and platelet counts. © Georg Thieme Verlag KG Stuttgart · New York.
19, 1914 12 M 10 No 1)iinag S-ept. 10, 1416 2 P)ITt is Nil Dama~e Aug 13, 1918H 1145 pmn 16 D~ouble track dietruyrd, 17 hours to rCliAtt St2516, 1918 ...this use of its bombing aviation) as carried out in the war of 1914 - 1918 is the lack of a predetermined program carefully calculated to destroy by...History," R-I, the correction Stuttgart, with munition works (23 August 1914 to 26 being the addition of the at Oberndorf as the alternate September 1918
Sperl, D; Benesch, M; Urban, C; Lackner, H; Sovinz, P; Speicher, M R; Uhrig, S; Schwarzbraun, T; Schwinger, W; zur Stadt, U; Beutel, K; Janka, G; Scarpatetti, M; Seidel, M G
Two related boys who died from fulminant infectious mononucleosis were diagnosed with X-linked lymphoproliferative disease type 1 (XLP-1). Family screening (n=17) identified 6 female mutation carriers and 2 more XLP-1 patients in whom, despite recurrent infections, agammaglobulinemia, and Hodgkin's Disease, the genetic basis had been unknown; demonstrating that awareness and early genetic testing are crucial to reveal underlying primary immunodeficiencies and improve outcome. Furthermore, XLP should be included routinely in the differential diagnosis of severe hypogammaglobulinemia and/or lymphoma in males. © Georg Thieme Verlag KG Stuttgart · New York.
The discovery of a hitherto unpublished dissertational thesis in the archive of a publishing house has lead to a lost publication by Ernst August Dölle. In this manuscript, the author reports on the stimulation of a cerebral libido area in the dog, long before Olds and Milner published their work on the discovery of the rewarding area. The reasons for the suppression of this early publication by Dölle are investigated and are ascribed to an effort to use his neurobiologic research for secret mental manipulation experiments of the CIA at the beginning of the Cold War. George Thieme Verlag KG Stuttgart · New York.
Protection of our drinking water resources and provision of safe drinking water are key requirements of modern water management and health policy. Microbiological and chemical quality standards have been established in the EU water policy since 1980, and are now complemented by a comprehensive protection of water as a resource. This contribution reflects a presentation at the scientific conference of the Federal Associations of Physicians and Dentists within the Public Health Service in May 2011 and provides an overview on objectives and challenges for drinking water protection at the European level. © Georg Thieme Verlag KG Stuttgart · New York.
Weber, Christian Friedrich; Zacharowski, Kai
New-generation methods for point of care based coagulation monitoring enable fully automated viscoelastic analyses for the assessment of particular parts of hemostasis. Contrary to the measuring techniques of former models, the viscoelastic ROTEM ® sigma and TEG ® 6s analyses are performed in single-use test cartridges without time- and personnel-intensive pre-analytical procedures. This review highlights methodical strengths and limitations of the devices and meets concerns associated with their integration in routine clinical practice. Georg Thieme Verlag KG Stuttgart · New York.
This guideline was presented in 2016 due to the need for an up to date evidence-based guidance focusing on patient safety. In addition to safety-related aspects of catheter insertion or removal, organisational issues and structured training concepts were discussed. The guideline was created based on the review of current literature as well as expert opinion. The article summarizes and discusses the most important recommendations and the reader is provided with practical advice for catheter insertion or removal with the intention to improve the safety of the patients. Georg Thieme Verlag KG Stuttgart · New York.
PMA-272). He was assigned to the U.S. European Command in Stuttgart, Germany from 1991 to 1994, serving in the Joint Petroleum Office as the Staff...Air Force Base, Florida from July 1990 to June 1993. He then served as Logistics Officer (G4) at 3rd Corps Support Command in Wiesbaden, Germany from...TURNOVER TO DESC FUEL SALES TO NORWAY AND EXCHANGES OF PRODUCT WITH GERMANY WILL LEAD TO TERMINATION OF AGREEMENTS WITH NORWAY AND DENMARK IN 2002 SOURCE
assigned to the U.S. European Command in Stuttgart, Germany from 1991 to 1994, serving in the Joint Petroleum Office as the Staff Petroleum Officer for...from July 1990 to June 1993. He then served as Logistics Officer (G4) at 3rd Corps Support Command in Wiesbaden, Germany from July 1993 to June 1995...successfully used the RDC system to collect fuel requirements for customers in the Germany PC&S and Hawaii PC&S programs. In August 2000, DESC used the
Belhadj Kouider, Esmahan; Dupont, Marc; Lorenz, Alfred L; Petermann, Franz
Distributions in children's or adolescents' mental disorders or in psychosocial pressures were demonstrated. The health care population in child- and adolescent psychiatric institutions of Bremen in 2005 - 2012 (N = 7190) was analyzed. Amongst other burden factors pressures in school context or abnormal social environments increased significantly. Adjustment stress disorders or externalizing disorders were dominant, but the prevalence in affective and anxiety disorders increased considerably. The co-operation with school authorities or agencies should be intensified. © Georg Thieme Verlag KG Stuttgart · New York.
Lang, Fabian U; Otte, Stefanie; Vasic, Nenad; Jäger, Markus; Dudeck, Manuela
The study aimed to investigate the correlation between impulsiveness and the antisocial personality disorder among short-term prisoners. The impulsiveness was diagnosed by the Barratt Impulsiveness Scale (BIS). Short-term prisoners with antisocial personality disorder scored significant higher marks on the BIS total scale than those without any personality disorder. In detail, they scored higher marks on each subscale regarding attentional, motor and nonplanning impulsiveness. Moderate and high effects were calculated. It is to be considered to regard impulsivity as a conceptual component of antisociality. © Georg Thieme Verlag KG Stuttgart · New York.
Mukherjee, Prasun; Das, Asish R; Mishra, Raghwendra; Bhowmick, Shovonlal; Saha, Achintya
We have evaluated the LDH inhibitory property of novel pyrazolo[4',3':5,6][1,4]oxathiino[2,3-b]pyrazine derivatives which have been synthesized from easily available starting materials through a one-pot protocol that offers the use of elemental sulfur as the sulfur source. These newly synthesized compounds may aid to drug development for neoplastic and non-neoplastic diseases characterized by increased glucose metabolism. Additionally, they may act as suitable starting materials which can be further structurally modified for the development of new LDH inhibitors with higher efficacy and specificity. © Georg Thieme Verlag KG Stuttgart · New York.
Röher, Katharina; Göpfert, Matthias S
In the light of a rising percentage of women among employees in anaesthesia and intensive care designing adequate workplaces for pregnant employees plays an increasingly important role. Here it is necessary to align the varied interests of the pregnant employee, fellow employees and the employer, where the legal requirements of the Maternity Protection Act ("Mutterschutzgesetz") form the statutory framework. This review describes how adequate workplaces for pregnant employees in anaesthesia and intensive care can be established considering the scientific evidence on the subject. © Georg Thieme Verlag Stuttgart · New York.
Fouilloux, Virginie; Gran, Célia; Kreitmann, Bernard
Surgical approach for persistent ductus arteriosus ligation is typically a left lateral thoracotomy opening the pleural-space with left lung retraction. We describe an alternative approach, with a minimally invasive anterior parasternal incision. This is particularly adapted to preterm infants weighing less than 1.5 kg. This approach ensures a good exposure of vessels. We believe that it is safe, reliable and reproducible. The learning curve should not be an issue for surgeons used to manage low weight patients. Georg Thieme Verlag KG Stuttgart · New York.
Richter, Dirk; Berger, Klaus
Throughout the western world, an increasing demand for psychiatric services is reported. However, a systematic review published in 2008 came to the conclusion that there is no sufficient evidence for increasing mental disorders in the recent decades. A systematic review on studies with repeating cross-sectional surveys in the general population, published since 2008, was conducted. 33 study results were included into the review. The majority of publications did not report increasing mental health problems in the general population. The increasing demand for psychiatric services is not associated with increasing mental disorders in the general population. © Georg Thieme Verlag KG Stuttgart · New York.
Haase, R; Beier, T; Bernstädt, M; Merkel, N; Bartnicki, J
Salmonella apapa is transmitted by reptiles, e.g., bearded dragons. To date only few cases of S. apapa-related human infections have been reported. Because the bacteria are transmitted through the feces of animals or direct contact with low infection doses, infection in early infancy is possible. We report an 18-day-old newborn with sepsis caused by Salmonella apapa. Salmonella apapa was isolated from the feces of a bearded dragon living along with the family. © Georg Thieme Verlag KG Stuttgart · New York.
Goerke, Sebastian M; Neubauer, J; Zajonc, H; Thiele, J R; Kotter, E; Langer, M; Stark, G B; Lampert, F M
During the last decade, DVT (digital volume tomography) imaging has become a widely used standard technique in head and neck imaging. Lower radiation exposure compared to conventional computed tomography (MDCT) has been described. Recently, DVT has been developed as an extremity scanner and as such represents a new imaging technique for hand surgery. We here describe the first 24 months experience with this new imaging modality in hand and wrist imaging by presenting representative cases and by describing the technical background. Furthermore, the method's advantages and disadvantages are discussed with reference to the given literature. © Georg Thieme Verlag KG Stuttgart · New York.
Frank, Fabian; Gräder, Nicola; Dahlmann, Hannah; Berger, Mathias; Hölzel, Lars
Examination of the attendance for using internet-based measures after inpatient treatment. Cross-sectional-survey in former inpatients (N = 247). 44.9 % are willing to use measures via videoconference, 34.7 % via Chat, 50.0 % via E-Mail and 38.0 % as onlinetherapy. Attendance is lower in older age groups. Benefits regarding the introduced measures are seen mainly in the flexibility and disadvantages in the impersonal character. A relevant share of especially younger patients is willing to use internet-based measures. © Georg Thieme Verlag KG Stuttgart · New York.
[Guideline for the Diagnosis and Treatment of Asthma - Guideline of the German Respiratory Society and the German Atemwegsliga in Cooperation with the Paediatric Respiratory Society and the Austrian Society of Pneumology].
Buhl, R; Bals, R; Baur, X; Berdel, D; Criée, C-P; Gappa, M; Gillissen, A; Greulich, T; Haidl, P; Hamelmann, E; Kardos, P; Kenn, K; Klimek, L; Korn, S; Lommatzsch, M; Magnussen, H; Nicolai, T; Nowak, D; Pfaar, O; Rabe, K F; Riedler, J; Ritz, T; Schultz, K; Schuster, A; Spindler, T; Taube, C; Taube, K; Vogelmeier, C; von Leupold, A; Wantke, F; Weise, S; Wildhaber, J; Worth, H; Zacharasiewicz, A
The present guideline is a new version and an update of the guideline for the diagnosis and treatment of asthma, which replaces the previous version for german speaking countries from the year 2006. The wealth of new data on the pathophysiology and the phenotypes of asthma, and the expanded spectrum of diagnostic and therapeutic options necessitated a new version and an update. This guideline presents the current, evidence-based recommendations for the diagnosis and treatment of asthma, for children and adolescents as well as for adults with asthma. © Georg Thieme Verlag KG Stuttgart · New York.
Siebert, C H; Becker, R; Buchner, M; Förster, J; Frosch, K-H; Losch, A; Niemeyer, P; Scheffler, S
The number of patients with meniscal injuries is increasing constantly, but the treatment algorithms are undergoing continuous change. The effects of meniscal surgery, as well as the indications for the procedure, are currently a matter of heated debate. Various German speaking associations addressing topics related to the knee have joined forces to develop guidelines for the diagnosis, evaluation and therapy of meniscal lesions. The hope is that this first of two publications will shed light on some of the ongoing issues and offer guidance to health care professionals treating these patients. Georg Thieme Verlag KG Stuttgart · New York.
Bernasconi, Barbara; Konrad, Christoph; Fischer, Simon
This case report describes the inadvertent poisoning of a young man with "poppers" after having ingested an unknown amout of the drug. "Poppers" (alkyl nitrite) were made famous in the 1960s as a party drug, and during certain sexual practices, and are still in use today. The drug's inhalation leads to a short-lived rush, vasodilation and relaxtion of smooth muscles. An accidental ingestion can lead to a significant build-up of methemoglobin with dire consequences. The therapy consists of the intravenous administration of methylene blue. © Georg Thieme Verlag Stuttgart · New York.
Panahi, Yunes; Mohammadhosseini, Majid; Nejati-Koshki, Kazem; Abadi, Azam Jafari Najaf; Moafi, Hadi Fallah; Akbarzadeh, Abolfazl; Farshbaf, Masoud
Gold nanoparticles (AuNPs) due to their unique properties and manifold surface functionalities have been applied in bio-nanotechnology. The application of GNPs in recent medical and biological research is very extensive. Especially it involves applications such as detection and photothermalysis of microorganisms and cancer stem cells, biosensors; optical bio-imaging and observing of cells and these nanostructures also serve as practical platforms for therapeutic agents. In this review we studied all therapeutic applications of gold nanoparticles in biomedicine, synthesis methods, and surface properties. © Georg Thieme Verlag KG Stuttgart · New York.
Doebler, O; Spierer, R
A full-thickness defect of the abdominal wall is rare and may occur as a complication of extended abdominal surgery procedures. We report about a 69-year-old patient who was presented to our department with a full-thickness abdominal wall defect and a fully exposed collagen-mesh for reconstructive wound closure. 13 operations with resections of necrotic parts of the abdominal wall were performed following a complicated intraabdominal infection. After debridement and mesh explantation, closure of the remaining defect of the lower abdominal region was achieved by a cutaneous groin flap. Georg Thieme Verlag KG Stuttgart New York.
Klein-Weigel, Peter; Volz, Theresa Sophie; Richter, Jutta
Thromboangiitis obliterans (Buerger's disease) is a vasculitis with undulating clinical course multisegmentarily affecting small and medium-sized arteries and veins. The disease is closely linked to tobacco-use. Increasing knowledge of autoimmunologic mechanisms in the complex pathophyiology of the disease let to the formulation of an autoimmunity-hypothesis now serving as a new paradigma. New treatment options comprise progenitor-cell-therapy, immunoadsorption, use of sendothelin-receptor-blocking agent Bosentan, and prescriptions of antiphosphodiesterase-V-inhibitors. © Georg Thieme Verlag KG Stuttgart · New York.
Since November 2015, businesslike assisted suicide is punishable in Germany. But who acts businesslike? The majority of the German population prefers to make own decisions about the circumstances of their arriving death, and many of them would also accept (physician) assisted suicide if necessary. Only a minority of physicians plead for prohibiting assisted suicide in general. In the end everyone should be able to take position on his own. No one is obliged to use or execute assisted suicide. © Georg Thieme Verlag KG Stuttgart · New York.
Morawa, Eva; Erim, Yesim
Comparative study on perceived discrimination and subjective health status in two immigrants samples. In a total sample consisting of 218 immigrants of Turkish and Polish origin perceived discrimination, depressiveness (BDI) and health related quality of life (SF-36) were assessed. Turkish immigrants have shown higher levels of perceived discrimination and depressiveness as well as a lower subjective quality of life. The results indicate that Turkish immigrants have a greater mental impairment compared to persons with Polish migration background. © Georg Thieme Verlag KG Stuttgart · New York.
Schröder, Torsten; Kistenmacher, Alina; Smollich, Martin; Sina, Christian
Patients with malassimilation suffer from disturbed exploitation of available nutrients, which can affect macro- and micronutrients. Malassimilation can be subdivided in maldigestion and malabsorption. Many different disorders, especially gastrointestinal diseases, can lead to malassimilation. The wide variety of differential diagnoses necessitates big diagnostic as well as financial efforts in order to assure good clinical care. This review provides an overview on diagnostic as well as therapeutic processes of patients with malassimilation and gives practical advice for their physicians and therapists. © Georg Thieme Verlag KG Stuttgart · New York.
Follath, R.; Schmidt, J. S.; Weigand, M.; Fauth, K.
The Max Planck Institute for Metal Physics in Stuttgart and the Helmholtz Center Berlin operate a soft X-ray microscopy beamline at the storage ring BESSY II. A collimated PGM serves as monochromator for a scanning X-ray microscope and a full field X-ray microscope at the helical undulator UE46. The selection between both instruments is accomplished via two switchable focusing mirrors. The scanning microscope (SM) is based on the ALS STXM microscope and fabricated by the ACCEL company. The full field microscope (FFM) is currently in operation at the U41-SGM beamline and will be relocated to its final location this year.
Polish psychiatry was since its origin deeply influenced by German (Austrian) and Russian psychiatry. After the German assault Polish psychiatric patients were the first victims of mass executions, and the first to be killed by new developed "gassing" technology. Especially cruel was the fate of Jewish patients. German "health policy" in occupied Poland was only "starvation or shooting". Some hospitals continued working under German rule and received patients from Germany in the framework of Nazi-"euthanasia". The article describes the mostly ignored facts of the close link between the medical programme of annihilation of the "unfit" and the genocide of Poles and Jews. © Georg Thieme Verlag KG Stuttgart · New York.
Dendup, Tshewang; Prachyawarakorn, Vilailak; Pansanit, Acharavadee; Mahidol, Chulabhorn; Ruchirawat, Somsak; Kittakoop, Prasat
Three new isoflavanones (1-3) and thirteen known compounds (4-16) were isolated from the roots of Mucuna pruriens. The absolute configurations of isoflavanones 1-3 and parvisoflavanone (4), lespedeol C (5), and uncinanone C (6) were addressed by a circular dichroism technique. Isoflavanones, isoflavones, and pterocarpans of M. pruriens were found to be α-glucosidase inhibitors. Medicarpin (7) and parvisoflavone B (9) were potent α-glucosidase inhibitors (twofold less active than the standard drug acarbose). The production of bioactive metabolites in M. pruriens seems to be season-dependent. Georg Thieme Verlag KG Stuttgart · New York.
Mechanical ventilation in patients with respiratory failure represents one of the most important aspects of intensity care. It can be performed invasively and non-invasively depending on the clinical situation and the underlying disease. The expenditure and consumption of resources is the basis of the compensation for each patient case in the German diagnosis related group system. For ventilated patients it is calculated based on the hours of ventilation, according to the standard coding guideline. In this statement, the German Respiratory Society and the Association of Pneumological Clinics aim to clarify some aspects of the coding of invasive and non-invasive ventilation. © Georg Thieme Verlag KG Stuttgart · New York.
The partial oxidation reaction of ethylene on neutral and anionic Ag 7 clusters has been studied using the BPW91 hybrid DFT method with the Stuttgart RSC97 relativistic pseudopotential for the 28-electron ionic core of Ag. The atomic oxygen reaction mechanism is mainly addressed. Results show that the reaction occurs via a stable oxametallacycle intermediate ( AgOCH4p, p = 0 or -1), but it involves small reaction barriers along the reaction path. The ZPE-corrected barrier heights are obtained as 0.7-6.5 kcal/mole. In addition, the structure and anionic effects of Ag 7 clusters are also discussed.
Pöhlmann, Tobias; Schmidt, Armin; Pohl, Wolfgang
Obstetrical emergencies requiring emergency medical service are very rare. An extremely premature birth in a preclinical setting is certainly exceptional. In the following case report, the emergency medical team was unexpectedly faced with the home birth of a fetus at the 23 rd week of gestation. Prematurity at the edge of viability poses a challenge to first care, equipment, infrastructure, expertise and clinical ethics. To the authors' knowledge, there is no comparable case report published so far. © Georg Thieme Verlag Stuttgart · New York.
Ahn, Joong Hyun; Suh, Jong Hui; Jeong, Jin Yong
Robot-assisted thoracoscopic surgery has been applied for general thoracic operations. Its advantages include not only those of minimally invasive surgery but also those of magnified three-dimensional vision and angulation of the robotic arm. However, there are no direct tactile sensation and force feedback, which can cause unwanted organ damage. We therefore used laparoscopy simultaneously to avoid a blind intraperitoneal area during robotic surgery for diaphragmatic eventration via transthoracic approach and describe the technique herein. Georg Thieme Verlag KG Stuttgart · New York.
Shedden-Mora, Meike; Lau, Katharina; Kuby, Amina; Groß, Beatrice; Gladigau, Maria; Fabisch, Alexandra; Löwe, Bernd
The management of somatoform disorders in primary care is often limited due to low diagnostic accuracy, delayed referral to psychotherapy and overuse of health care. To address these difficulties, this study aimed to establish a collaborative stepped health care network (Sofu-Net). Sofu-Net was established among 41 primary care physicians, 35 psychotherapists and 8 mental health clinics. Baseline assessment in primary care showed elevated psychopathology and deficits in health care among patients with somatoform symptoms. Network partners provided positive evaluations of Sofu-Net. © Georg Thieme Verlag KG Stuttgart · New York.
Romano, Ron; Baum, Neil
Social media has changed the landscape of online interaction for all doctors including pediatric surgeons. Of course the public including our patients and potential new patients having immediate access to these sites through mobile devices and iPads has contributed immensely to this phenomenon. Nonetheless, it seems that we are all rushing to get in front of our target audience and to engage in a relationship with them in a cost-effective fashion. This article will discuss the role of the Internet and media and how you can use this technology to attract new pediatric patients to your practice. Georg Thieme Verlag KG Stuttgart · New York.
Harbeck, B; Berndt, M J; Lehnert, H
A 51-year-old man presented with progressive tiredness, proximal muscle weakness, hair loss and weight gain for months. The patient showed mild pretibial myxedema and dry skin. Laboratory findings revealed strongly elevated cardiac enzymes as well as marked hypothyroidism. The electrocardiogram, echocardiography, abdominal sonography and chest X-ray were unremarkable. Thyroid ultrasound demonstrated features of Hashimoto thyroiditis. The findings supported the diagnosis of an overt hypothyroidism with myxedema and rhabdomyolysis. After starting levothyroxine and volume substitution laboratory parameters and clinical condition slowly normalized. Severe overt hypothyroidism may rarely present primarily as myopathy with myositis and cardiac involvement. © Georg Thieme Verlag KG Stuttgart · New York.
Kerwat, Klaus; Kerwat, Martina; Eberhart, Leopold; Wulf, Hinnerk
The results of microbiological tests are the foundation for a targetted therapy and the basis for monitoring infections. The quality of each and every laboratory finding depends not only on an error-free analytical process. The pre-analysis handling procedures are of particular importance. They encompass all factors and influences prior to the actual analysis. These include the correct timepoint for sample taking, the packaging and the rapid transport of the material to be investigated. Errors in the pre-analytical processing are the most frequent reasons for inappropriate findings. © Georg Thieme Verlag Stuttgart · New York.
Splieth, C H; Franze, M; Plachta-Danielzik, S; Thyrian, J R; Schmidt, C O; John, U; Kohlmann, T; Müller, M J; Hoffmann, W
The main goal of this study was the evaluation of an intervention programme for the promotion of health literacy in school-aged children (grade 5-6). The project and the programme were highly accepted, the extension of the annual dental health examination was suitable to collect data within evaluation projects in schools. In spite of positive outcomes, a longer supervision phase would be necessary in order to optimise and to implement other programme components fully. © Georg Thieme Verlag KG Stuttgart · New York.
Vonend, Oliver; Böhm, Michael; Eckert, Siegfried; Hausberg, Martin; Rittger, Harald; Rump, Lars-Christian; Schmieder, Roland; Schulte, Karl-Ludwig; Schunkert, Heribert; Uder, Michael; Veelken, Roland; Vorwerk, Dierk; Weil, Joachim; Wenzel, Ulrich; Mahfoud, Felix
Arterial hypertension is a major risk factor for cardiovascular mortality and remains insufficiently controlled in Germany. The sham controlled Symplicity HTN-3 trial did meet its primary safety endpoint but failed to meet its primary efficacy endpoint. Renal denervation can not replace established, well-proven therapies. It can only be used in selected truly resistant hypertensive patients as an additive approach and should be performed by specialized centers only. Randomized controlled trials are needed to further evaluate renal denervation. © Georg Thieme Verlag KG Stuttgart · New York.
Oechtering, G U; Schlüter, C; Lippert, J P
Selective breeding for exaggerated features caused in many brachycephalic dog and cat breeds virtually a loss of the nose, with serious anatomical and functional consequences. In addition to respiratory and olfactory tasks, in dogs the nose is of vital importance for thermoregulation. As obligatory nose breathers, dogs suffer far more than humans when their nasal ventilation is restricted. An open discussion in the broad public has to motivate authorities and kennel clubs to recognize extreme brachycephalic breeding as seriously affecting animal health and welfare. Copyright Georg Thieme Verlag KG Stuttgart . New York.
Prasaja, Budi; Syabani, M Maulana; Sari, Endah; Chilmi, Uci; Cahyaningsih, Prawitasari; Kosasih, Theresia Weliana
Sevelamer carbonate is a cross-linked polymeric amine; it is the active ingredient in Renvela ® tablets. US FDA provides recommendation for demonstrating bioequivalence for the development of a generic product of sevelamer carbonte using in-vitro equilibrium binding study. A simple UV-vis spectrophotometry method was developed and validated for quantification of free phosphate to determine the binding parameter constant of sevelamer. The method validation demonstrated the specificity, limit of quantification, accuracy and precision of measurements. The validated method has been successfully used to analyze samples in in-vitro equilibrium binding study for demonstrating bioequivalence. © Georg Thieme Verlag KG Stuttgart · New York.
Hung, Tran Manh; Dang, Nguyen Hai; Kim, Jin Cheol; Jang, Han-Su; Ryoo, Sung-Woo; Lee, Jeong Hyung; Choi, Jae Sue; Bae, Kihwan; Min, Byung Sun
In the course of screening plants used in folk medicine as memory enhancers, a 70% ethanolic extract of Stephania rotunda roots showed significant AChE inhibitory activity. Repeated column chromatography led to the isolation of a new protoberberine alkaloid, which we named stepharotudine (1), and seven known compounds (2-8). The chemical structures of the isolated compounds were elucidated based on extensive 1D and 2D NMR spectroscopic data. Compounds 1-8 were investigated in vitro for their anticholinesterase activity using a rat cortex AChE enzyme. © Georg Thieme Verlag KG Stuttgart · New York.
Ottomann, C; Frenzel, R; Muehlberger, T
The booming cruise industry, associated with ships with more passengers and crew on board, results in growing medical needs for the ship doctor. The ship's doctor insurance policy includes different jurisdictions, namely national law, international law, tort law, insurance law and labor law. In addition, international agreements must be taken into account, which complicates the design of an adequate insurance policy. Equally high are the costs and defense costs for the ship's doctor in case of liability. In order to limit the liability for all parties is to ask for appropriately qualified medical staff, hired on board. © Georg Thieme Verlag KG Stuttgart · New York.
Bermejo, I; Frank, F
In migrants alcohol-related problems increase with increasing age. This group, in particular, is hardly reached by alcohol-specific care offers. Thus our project aimed at the identification of target group-specific barriers to health-care use by means of a cross-sectional study (n=435). Based on these results a trans-cultural concept for alcohol prevention among elderly migrants was developed and evaluated in a cluster-randomised controlled trial (n=176). © Georg Thieme Verlag KG Stuttgart · New York.
Röhnsch, Gundula; Flick, Uwe
Which representations of care can be found in migrants with alcohol or drug problems from the former Soviet Union? How do they correspond with views in the care system? Episodic interviews with 46 migrants, expert interviews with 33 service providers; analysis with thematic coding. For migrants and experts holistic care is important, which include spiritual-religious components but are also control-oriented. The cultural specificity of migrants' care representations should be acknowledged by the health care system much more. © Georg Thieme Verlag KG Stuttgart · New York.
Zastrow, Armin; Wittwer, Volker
The interest in efficient daylighting systems has grown recently, due to their potential for saving a considerable amount of electrical energy used for lighting purposes. In this paper we discuss the properties of daylighting systems based on either fluorescent planar concentrators and transparent light guiding plates or light pipes coated with highly reflective silver coated plastic films. Finally we give first results from a demonstration project, daylighting systems in the students' living quarters in Stuttgart-Hohenheim, which is supported by the Commission of the European Communities.
Boschin, Matthias; Vordemvenne, Thomas
Injuries remain the leading cause of death in children and young adults. Management of multiple trauma patients has improved in recent years by quality initiatives (trauma network, S3 guideline "Polytrauma"). On this basis, strong links with preclinical management, structured treatment algorithms, training standards (ATLS®), clear diagnostic rules and an established risk- and quality management are the important factors of a modern emergency room trauma care. We describe the organizational components that lead to successful management of trauma in hospital. © Georg Thieme Verlag Stuttgart · New York.
Prokop, A; Schiffer, G; Jubel, A; Chmielnicki, M
With an incidence of 64/100,000, clavicular shaft fractures are one of the most common fractures. Intramedullary fixation with Prevot nails was initially reported in the late 1990s. This procedure offers minimally invasive stabilization of the fracture, thus enabling immediate mobilization and rapid loading capacity. Using a case study, the positioning and procedure are demonstrated on video. The intramedullary implant accommodates the varying tension loading of the clavicle. This treatment is ideal for clavicular fractures with 2-3 fragments. Compared to patients treated conservatively, operated patients achieve more rapid and improved mobility. Employment disability is shorter, and malunion occurs less frequently. Georg Thieme Verlag KG Stuttgart · New York.
Volkert, Dorothee; Sieber, Cornel C; Wirth, Rainer
Older people suffering from dementia are at increased risk of malnutrition due to various nutritional problems, and the question arises which interventions are effective in maintaining adequate nutritional intake and nutritional status in the course of the disease. In an international expert group, initiated by the European Society for Clinical Nutrition and Metabolism (ESPEN), 26 evidence-based recommendations for nutritional care of older persons with dementia have been developed, covering the topics of screening and assessment of malnutrition, strategies to support oral nutrition, oral supplementation and artificial nutrition. This article is a short version of the guideline. © Georg Thieme Verlag KG Stuttgart · New York.
Weigel, Angelika; Gumz, Antje; Kästner, Denise; Romer, Georg; Wegscheider, Karl; Löwe, Bernd
The "Health care network anorexia and bulimia nervosa", a subproject of psychenet - the Hamburg network for mental health - aims to decrease the incidence of eating disorders as well as the risk for chronic illness courses. One focal project, therefore, evaluates a school-based prevention manual in a randomized controlled trial. The other one examines the impact of a systemic public health intervention on early treatment initiation in anorexia nervosa. The present article provides an overview about study design and interventions in both focal projects as well as preliminary results. © Georg Thieme Verlag KG Stuttgart · New York.
Löbermann, M; Gürtler, L G; Eichler-Löbermann, B; Reisinger, E C
Emergence of viral agents in Europe is influenced by various factors. Climatic changes influencing possible vectors, insufficient vaccination, and travel of man and goods are among the most important reasons to explain these changes. Fever and arthralgia are the leading symptoms in infection with Dengue, Sindbis, or Chikungunya virus. In contrast, tick-born encephalitis (TBE), Toscana, or West Nile virus infections mainly lead to meningo-encephalitis. In Europe, hemorrhagic fever is caused by Crimean Congo and Hanta virus. Protective vaccines are available for emerging viral agents like TBE, influenza and measles. © Georg Thieme Verlag KG Stuttgart · New York.
Rohrbach, J M; Harbeck, M; Holzhauser, P; Tekeva-Rohrbach, C I; Mach, M; Codreanu-Windauer, S
During an excavation in Regensburg/Germany the skeleton of an approximately 20-year-old Roman man was found who was buried in the 3rd/4th century after Christ. A "stone" was found which fitted into the left orbit precisely. After a thorough investigation of the "stone" and with the ophthalmohistorical literature in mind an orbital "implant" as well as a petrified medical paste ("Kollyrium") could be ruled out almost with certainty. Possibly the "stone" served another medical purpose or was used for protection of the eye. Georg Thieme Verlag KG Stuttgart · New York.
Heumann, Kolja; Schmid, Christine; Wilfer, Antje; Bolkan, Suzan; Mahlke, Candelaria; von Peter, Sebastian
This study explores the peer support providers' competencies and role experiences. A multiple coding approach has been used to collaboratively analyze and discuss ethnographic material. Compared to other professionals, peer support provider engage with patients in a more open and less classificatory way. Their role is often unclear and defined by both more flexibility and dependencies. It is important to clearly define the competencies and roles of peer support providers and balance them with the expectations of the other professionals. © Georg Thieme Verlag KG Stuttgart · New York.
Gühne, Uta; Weinmann, Stefan; Arnold, Katrin; Atav, Esra-Sultan; Becker, Thomas; Riedel-Heller, Steffi
To report about existing evidence of effectiveness of home treatment for severely mentally ill adults and implementation in Germany. Systematic electronic and manual literature search. Compared to standard care, home treatment was equally or more efficacious with respect to general state of health and mental health. Home treatment was superior with regard to other outcomes. So far, implementation in Germany is limited. Home treatment can be seen as an effective addition to existing approaches of psychiatric care. It may be cost-effective also in Germany. Reasons for limited implementation in routine care are discussed. © Georg Thieme Verlag KG Stuttgart · New York.
Enders, Christian; Lang, Gabriele E; Lang, Gerhard K; Werner, Jens Ulrich
Quality management improves the structures, processes and results of organizations of all kinds. Many practices and clinics have their existing quality management system certified according to ISO 9001, (e.g., to check their own quality management system or to obtain a testimonial against third parties). The latest version ISO 9001:2015 contains some changes, both structurally and in terms of content. These changes can be met with reasonable efforts. An ISO 9001:2015 certification represents a value for your organization, but these advantages are often not directly measurable. Georg Thieme Verlag KG Stuttgart · New York.
Graf, Matthias; Stiller, Patrick; Karch, Martin
Symptomatic bradycardia is usually caused by abnormalities of atrioventricular conduction or sinus node dysfunction. Reversible and irreversible causes must be considered.Temporary pacemakers are used in the emergency treatment in case of severe bradyarrhythmia.They help to bridge the acute phase until spontaneous restoration of atrioventricular or sinus node function or -if spontaneous restoration fails- until a permanent pacemaker system was implanted.In the following article we discuss the commonly used temporary pacemaker systems. We demonstrate their use and correct programming by an illustrated step by step explanation. For troubleshooting a flow chart was added. © Georg Thieme Verlag KG Stuttgart · New York.
Kauther, M D; Rummel, S; Hussmann, B; Lendemans, S; Nast-Kolb, D; Wedemeyer, C
The cyr wheel is a modified gymnastic wheel with only one ring that can lead to extreme forces on the gymnast. We report on a distal radius shaft fracture (AO 22 A 2.1) and a fracture of the styloid process of the ulna that occurred after holding on to a slipping Cyr wheel and exposition to high pressure on the lower arm. The fracture was fixed by screws and a plate. © Georg Thieme Verlag KG Stuttgart · New York.
Lackner, N; Birner, A; Bengesser, S A; Reininghaus, B; Kapfhammer, H P; Reininghaus, E
In recent years, intense controversies have evolved about the existence and exact diagnostic criteria of pediatric bipolar affective disorder. The present study aims to discuss pediatric bipolar affective disorder based on the current literature focussing on the diagnostic prospects. Based on a case study, a process of bipolar disorder developed in childhood is depicted exemplarily. Because of the high comorbidity and overlapping symptoms of paediatric bipolar affective disorder and other psychiatric disorders, the major impact of the differential diagnosis has to be stressed. An early diagnosis and the treatment possibilities are discussed. © Georg Thieme Verlag KG Stuttgart · New York.
Based on risk coefficients for cardiovascular and psychiatric disease derived from a case-control study in the vicinity of a major German airport, statistics on persons exposed to night-time railroad noise in the vicinity of the Rotterdam-Genova Transversal, and on health expenditure calculations by the Federal Statistical Office of Germany a prognosis on effects of railroad noise was performed. It resulted for 1 10-year period in nearly 75 000 excess cases of diseases, nearly 30 000 excess deaths and health expenditures of 3.8 billion euros. © Georg Thieme Verlag KG Stuttgart · New York.
Reutlinger, Julia; Müller-Tasch, Thomas; Schellberg, Dieter; Frankenstein, Lutz; Zugck, Christian; Herzog, Wolfgang; Lossnitzer, Nicole
Depressive patients with chronic heart failure (CHF) show less social integration and greater physical impairment as well as poorer compliance than non depressive CHF patients. Using multiple regression analyses, this study (n=84) investigated a potential mediating effect of depression on the relationship between compliance and both social support and physical functioning. Results did not support the hypothesized mediating effect of depression. However, the variables age, depression, left ventricular ejection fraction (LVEF) and social support were associated with self-reported compliance. Therefore, a lack of social support and depression should be considered as possible reasons, if patients are noncompliant during the treatment process. © Georg Thieme Verlag KG Stuttgart · New York.
Angelopoulos, Elias; Theleritis, Christos; Economou, Marina; Georgatou, Korina; Papageorgiou, Charalambos C; Tsaltas, Eleftheria
In the recent study by Verhoeven and Egger, 2015 and the recent letter to the editor by Boot et al. 2015 an emphasis is given to the best possible pharmacological treatment of 22q11-2 Deletion-Syndrome related psychoses. We would like to present the case of a 23-year old Cypriot patient with 22q11.2 deletion syndrome who fulfilled criteria for treatment resistant schizophrenia (TRS). He was sequentially treated with aripiprazole, risperidone, olanzapine, haloperidol and a combination treatment with olanzapine and haloperidol. Clozapine was the only antipsychotic medication that has improved his condition. © Georg Thieme Verlag KG Stuttgart · New York.
Vondran, F W R; Wintterle, S; Bräsen, J H; Haller, H; Klempnauer, J; Richter, N; Lehner, F; Schiffer, M
In cases of chronic renal insufficiency, successful kidney transplantation is the method of choice to restore patients' health, well-being and physical fitness. The interdisciplinary collaboration of nephrologists and transplant surgeons has always been a prerequisite for the successful pre-, peri- and post-transplant care of renal transplant patients. The same holds true for liver transplant patients. Here the nephrologist is often involved in cases requiring pre- or post-transplant dialysis as well as in decision making for combined liver-kidney transplantation. This review focuses on nephrological aspects in patient care before and after kidney and liver transplantation. Georg Thieme Verlag KG Stuttgart · New York.
Sanner, Bernd; Hausberg, Martin
In patients with hypertension without diabetes and with an increased risk of cardiovascular complications a blood pressure of below 130 mmHg should be targeted. Hypertensive patients with an age above 80 years should be treated in the same way as younger hypertensive patients if they are otherwise healthy and functionally independent. On the other hand frail elderly patients could have an increased morbidity and mortality with intensive blood pressure control. In patients with resistant hypertension spironolactone was the most effective drug when given in addition to their baseline drugs (ACE-inhibitor/angiotensin receptor antagonist, calcium channel blocker and thiazide diuretic). © Georg Thieme Verlag KG Stuttgart · New York.
The Socio-Economic Panel (SOEP) has outstanding analytical potential for research on immigrants' mental health and quality of life. This article examines the quality of sampling, the composition and percentage of respondents in the SOEP sample with an immigrant background, and the indicators available in the SOEP on topics of mental health and quality of life. The concluding overview of the existing literature on these topics and of the SOEP's new refugee sub-sample underscores that the SOEP's potential for addressing these questions is far from exhausted. © Georg Thieme Verlag KG Stuttgart · New York.
Wiese, Christoph H R; Zink, Wolfgang; Russo, Sebastian G
In medical systems, economic issues and means of action are in the course of dwindling human (physicians and nurses) and financial resources are more important. For this reason, physicians must understand basic economic principles. Only in this way, there may be medical autonomy from social systems and hospital administrators. The current work is an approach to present a model for strategic planning of an anesthesia department. For this, a "strengths", "weaknesses", "opportunities", and "threats" (SWOT) analysis is used. This display is an example of an exemplary anaesthetic department. © Georg Thieme Verlag Stuttgart · New York.
In Germany aprox. 15% of all employees have irregular or flexible working hours. Disturbed sleep and/or hypersomnia are direct consequences of shift work and therefore described as shift work disorder. Beyond this, shift work can also be associated with specific pathological disorders. There are individual differences in tolerance to shift work. Optimization of both shift schedules and sleep to "non-physiological" times of the day are measures to counteract the negative effects of shift work. There is still not enough evidence to recommend drugs for routine use in shift workers. © Georg Thieme Verlag Stuttgart · New York.
The study examines the interaction of the forced married migrants and the frequency of the psychological illness. Forced-married and not forced-married migrants are compared concerning her psychological illness in psychosomatic clinics in Germany. Forced-married women reported significantly more about psychological illness and have undertaken on average at least four times a suicide attempt. Forced-married women suffer lifelong from this event and need, with taking into account cultural migration-specific aspects, special support in the psychosocial consultation and medical-therapeutic treatment. © Georg Thieme Verlag KG Stuttgart · New York.
Schwarze, Martin; Gerigk, Carina; Schulmeister, Martin; Schiltenwolf, Marcus
The orthopedic medical history of the now 56-year-old Mr. Z began immediately after his birth with an inpatient clubfoot therapy. With the onset of adolescence, multilocular pain began. The long-standing patient career was characterized by disappointment about the early onset and recurrent need for treatment. The disappointment motive is closely related to the relationship between the patient and his mother. The biography illustrates the intertwining of early (orthopedic) treatment, primary bonding and disease experiences. A multimodal pain therapy was able to target Mr. Z, create positive body experiences and finally reduce the pain. © Georg Thieme Verlag KG Stuttgart · New York.
Maatouk, Imad; Helaß, Madeleine
Demographic change leads to shifting demands in patient care, not only due to older and sicker patients, but also due to ageing and potentially strained nursing staff. High job strain is known to be associated with an intention to leave the job. At the same time prevalence of mental distress is already high. The aim of our work was to develop a small group intervention to prevent mental strain and to enhance healthy ageing at work. © Georg Thieme Verlag KG Stuttgart · New York.
Lambert, Martin; Härter, Martin; Brandes, Andreas; Hillebrandt, Bernd; Schlüter, Catarina; Quante, Susanne
The Hamburg Network for Mental Health belongs to the healthcare regions in Germany, funded by the Federal Ministry of Education and Research from 2011 to 2015. More than 330 partners from research, health care, health industry and government are promoting innovative health care models and products to improve mental health care in Hamburg. The main objectives comprise the sustained implementation of the Network itself and of successful health care models and products. The article describes current and future implementation possibilities and the present state of the implementation process. © Georg Thieme Verlag KG Stuttgart · New York.
In this issue, Bollling et. al. review the development of treatment of Ewing sarcoma as it evolved over the past 30 years of clinical trials in Europe, largely under the leadership of Heribert Jurgens to whom this review is dedicated. The 44 authors were teachers, colleagues, students and co-investigators of Jurgens. The authors attribute the ability to make progress in the treatment of Ewing sarcoma through the establishment of larger and still larger cooperative studies in order to demonstrate statistically significant advances in the treatment of this rare disease. © Georg Thieme Verlag KG Stuttgart · New York.
Beer, Sabrina; Hartlieb, Till; Müller, Arnd; Granel, Michael; Staudt, Martin
A total of 30 children and adolescents with dysphagia due to various chronic neurological disorders were assessed for their risk of aspiration. This assessment was performed clinically by experienced speech and swallowing therapists, and verified thereafter by fiberoptic endoscopy. We found the clinical judgment to be correct in only 70% (for aspiration of saliva), 55% (of puree), and 67% (of thin liquids). We conclude that, because of this unacceptably high error rate of clinical assessment, a fiberoptic evaluation of swallowing is a necessary diagnostic step both for the planning of therapy and for the development of feeding strategies in children and adolescents with neurogenic dysphagia. Georg Thieme Verlag KG Stuttgart · New York.
Franz, T; Krawczyk, T; Eggli, S; Wartburg, U von
A giant cell tumour of the distal radius or of the carpal bones, verified by incisional biopsies, should be approached as a low-grade malignancy. Lesions that arise in the bones of the hand or the wrist have a greater propensity to metastasise, and have a higher risk of local recurrence. In this case report we describe a 54-year-old women with a giant cell tumour of the distal radius (Campanacci grade III lesion), having a follow-up of five years without signs of local recurrence or metastatic disease. The general principles of and options for surgical treatment are discussed. © Georg Thieme Verlag KG Stuttgart · New York.
Lux, H; Cavalcante, L Barreira; Baur, X
Hilar and mediastinal lymphadenopathy may represent a diagnostic challenge in clinical practice. This article is intended to facilitate differential diagnosis by a systematic description of relevant pathologies, notably with occupational etiology. Clinical findings of relevant diseases, i. e. of tuberculosis, chronic beryllium disease, sarcoidosis, lung cancer, malignant lymphoma, Epstein-Barr virus infection, and histoplasmosis are compared.Case history, imaging and laboratory tests have important diagnostic impact. But also invasive methods can be necessary in order to exclude and prove malignancy, infection or autoimmune disease. © Georg Thieme Verlag KG Stuttgart · New York.
Bleiziffer, Sabine; Mazzitelli, Domenico; Nöbauer, Christian; Ried, Thomas; Lange, Rüdiger
Transcatheter aortic valve implantation was predominantly developed for patients with severe calcified aortic stenosis, as most devices are designed to anchor within the native valve calcium. We report on a patient with pure insufficiency of a non-calcified aortic valve, in whom an anatomically oriented catheter valve was implanted successfully. The design of the prosthesis with position feelers engaging the native aortic valve leaflets proved to be suitable for the treatment of pure aortic insufficiency. Georg Thieme Verlag KG Stuttgart · New York.
Kleinwechter, Helmut; Demandt, Norbert
In Germany in 5.5% of all births diabetes is registered. In patients with type 1 and type 2 diabetes planning pregnancy, preconception counseling, diabetologic care with optimized periconceptional metabolic control and folic acid supplementation are essential for good pregnancy outcome. Gestational diabetes (GDM) should be diagnosed timely and managed according to existing guidelines. GDM is treated with insulin in approximately 20%. In 1-2% of GDM cases a glucokinase gene mutation is present (MODY 2). Pregnancies after bariatric-metabolic surgery are increasing and show high risks. © Georg Thieme Verlag KG Stuttgart · New York.
Richter, Dirk; Hertig, Res; Hoffmann, Holger
Background: For many decades, psychiatric rehabilitation in the German-speaking countries is following a conventional linear continuum approach. Methods: Recent developments in important fields related to psychiatric rehabilitation (UN Convention on the Rights of People with Disabilities, theory of rehabilitation, empirical research) are reviewed. Results: Common to all developments in the reviewed fields are the principles of choice, autonomy and social inclusion. These principles contradict the conventional linear continuum approach. Conclusions: The linear continuum approach of psychiatric rehabilitation should be replaced by the "supported inclusion"-approach. © Georg Thieme Verlag KG Stuttgart · New York.
Schnabel, Alexander; Haaga, Roland; Rittner, Heike L
Within this case report we describe and discuss the treatment of a patient with chronic low back pain complaining about severe pain, reduced functionality and symptoms of depression, who was treated with long-term opioids (480 mg morphine equivalents). According to the recommendation of current guidelines we successfully reduced the opioid daily dose and discharged the patient with 28 mg morphine equivalents, improved physical functionality and reduced chronic pain intensity following a specific interdisciplinary pain rehabilitation programme for seniors. Georg Thieme Verlag KG Stuttgart · New York.
Harmsen, S; Mayatepek, E; Klee, D; Meissner, T
Bloody nipple discharge in adults is, in men as well as in women, often a symptom of an underlying malignant disease. In respect of this, multiple invasive and mutilating diagnostic procedures have been performed in infants and older children. Apart from individual cases in older and pubertal children, in childhood benign conditions are most common and can be diagnosed by non-invasive diagnostic procedures. Here we discuss a rational diagnostic approach on the basis of 2 patients with bloody nipple discharge at the age of 8 and 9 months which resolved spontaneously without treatment after 3 and 6 months, respectively. (c) Georg Thieme Verlag KG Stuttgart-New York.
The aim of this study is to show that Friedrich Schiller (1759 - 1805) was very early in life inclined towards psychosomatic interactions. An analysis of the secondary literature since the death of Friedrich Schiller for the subjects "Friedrich Schiller" and "psychosomatics" was undertaken. Already during his medical studies at the "Hohe Karlsschule" in Stuttgart (Germany) Schiller studied very intensively psychosomatic issues on account of the disease of another student, Joseph Frédéric Grammont, and included the topic in his three theses. Not inclined to practical work as a physician, there are many psychosomatic thoughts and medical concepts in his writings, especially in the play "Die Räuber" (1781) and in "Don Carlos, Infant von Spanien" (1787). Towards the then upcoming topic mesmerism he remained very sceptic. In coping with his own illness there are many psychosomatic aspects, too. Despite his own severe somatic illness he could cope with pain and emphasised in his writings the importance of the freedom of anxiety before death. © Georg Thieme Verlag KG Stuttgart · New York.
Winter, Gabriele; Schaub, Karlheinz G; Großmann, Kay; Laun, Gerhard; Landau, Kurt; Bruder, Ralph
Occupational hazards exist, if the design of the work situation is not in accordance with ergonomic design principles. At assembly lines ergonomics is applied to the design of work equipment and tasks and to work organisation. The ignoring of ergonomic principles in planning and design of assembly work leads to unfavourable working posture, action force and material handling. Disorders of the musculoskeletal system are of a common occurrence throughout Europe. Musculoskeletal disorders are a challenge against the background of disabled workers. The changes in a worker's capability have to be regarded in the conception of redesigned and new assembly lines. In this way ergonomics becomes progressively more important in planning and design of vehicles: The objective of ergonomic design in different stages of the vehicles development process is to achieve an optimal adaptation of the assembly work to workers. Hence the ergonomic screening tool "Design Check" (DC) was developed to identify ergonomic deficits in workplace layouts. The screening-tool is based on the current ergonomic state of the art in the design of physical work and relevant EU legal requirements. It was tested within a federal German research project at selected work stations at the assembly lines at Dr.-Ing. h.c. F. Porsche AG / Stuttgart. Meanwhile the application of the screening-tool DC is transferred in other parts of the Porsche AG, Stuttgart. It is also realized as an ergonomic standard method to perform assembly work in different phases of the vehicle development process.
Olsen, Kenneth H.; Ansorge, Joerg
Stephan Mueller, professor emeritus at the Institute of Geophysics at the Swiss Federal Institute of Technology (ETH) in Zurich and highly respected leader of international geoscience, died February 17, 1997. His untimely death, due to pneumonia following intestinal surgery, came just 18 months after his retirement from the ETH Chair of Geophysics and Directorship of the Swiss Seismological Service. He is survived by his wife, Doris, two sons, and six grandchildren. Mueller received a diploma in physics at the University of Stuttgart in 1957 and an M.S. in electrical engineering from Columbia University in New York in 1959. As an undergraduate at Stuttgart, he was influenced by seismologist Wilhelm Hillerand geophysics quickly became his major academic and career objective. After receiving a 1954-1955 German Academic Interchange Scholarship at Columbia, Mueller sought out Maurice Ewing and his group at Lamont Geological Observatory, where Mueller's enthusiasm for geophysics was strongly encouraged. While at Lamont, he participated in the first U.S. deep-sea geophysical expedition in the Mediterranean Sea during the summer of 1956 aboard the RV Vema.
From 1954 to 1960, 10 fatal cases of leukemia were recorded in Stuttgart among tuberculous patients over 14 yr of age, in a sample equivalent to 91,549 person-year. In contrast to these 10 cases, 5.86 cases of fatal leukemia were recorded in a corresponding sample of the general population of Stuttgart in the same period, or 233 cases in the total population. Leukemia in the tuberculous patients, who were presumably exposed to more frequent chest roentgenography than control subjects, was in 1 case of the chronic myeloid type, 4 of the acute myeloid type, and 5 of the lumphoid type.more » Only 2 cases were under 50 yr of age and the sex distribution was 5: 5. In none of the 10 cases was radiation exposure excessive. in fact, case records showed that their exposure was slightly lower than for the whole sample of tuberculous subjects. In view of this fact and because the incidence of leukemia is not statistically significantly greater in these subjects than in the general population, thoracic diagnostic radiography did not appear to favor development of leukemia in these subjects.« less
Eickhoff, Jens; Stratton, Sam; Butz, Pius; Cook, Barry; Walker, Paul; Uryu, Alexander; Lengowski, Michael; Roser, Hans-Peter
As already published in papers at the DASIA conferences 2010 in Budapest  and 2011 in Malta , the University of Stuttgart, Germany, is developing an advanced 3-axis stabilized small satellite applying industry standards for command/control techniques, onboard software design and onboard computer components. The satellite has a launch mass of approx. 120kg. One of the main challenges was the development of an ultra compact and performing onboard computer (OBC), which was intended to support an RTEMS operating system, a PUS standard based onboard software (OBSW) and CCSDS standard based ground/space communication. The developed architecture is based on 4 main elements (see [1, 2] and Figure 3) which are developed in cooperation with industrial partners:• the OBC core board based on the LEON3 FT architecture,• an I/O Board for all OBC digital interfaces to S/C equipment,• a CCSDS TC/TM decoder/encoder board,• reconfiguration unit being embedded in the satellite power control and distribution unit PCDU.In the meantime the EM / Breadboard units of the computer have been tested intensively including first HW/SW integration tests in a Satellite Testbench (see Figure 2). The FM HW elements from the co-authoring suppliers are under assembly in Stuttgart.
This article examines three so far unknown lemmatic commentaries on computus and on astrolabe topics, which are to be found in MS Stuttgart, Württembergische Landesbibliothek, Cod. math. 4 degrees 33 (second half of the twelfth-century). The commentaries are on the 'Compotus' by Gerlandus, on the 'De mensura astrolabii' by Hermann of Reichenau, and on the 'De utilitatibus astrolabii', which is sometimes attributed to Gerbert of Aurillac. No commentaries on the respective treatises have previously been identified as such. The commentaries of the Stuttgart manuscript are of special interest in that they allow us to understand how a twelfth-century scholar read works on computus and the astrolabe, namely works that date back to the eleventh century. Their author remains anonymous, but in all probability he wrote his commentary on the 'Compotus' by Gerlandus either in 1143 or in 1150. An appendix to the article includes transcriptions of the introductory texts on the computus and on the astrolabe as well as the beginnings of the commentaries.
Klouwer, Femke C C; Huffnagel, Irene C; Ferdinandusse, Sacha; Waterham, Hans R; Wanders, Ronald J A; Engelen, Marc; Poll-The, Bwee Tien
Peroxisomal disorders are a heterogeneous group of genetic metabolic disorders, caused by a defect in peroxisome biogenesis or a deficiency of a single peroxisomal enzyme. The peroxisomal disorders include the Zellweger spectrum disorders, the rhizomelic chondrodysplasia punctata spectrum disorders, X-linked adrenoleukodystrophy, and multiple single enzyme deficiencies. There are several core phenotypes caused by peroxisomal dysfunction that clinicians can recognize. The diagnosis is suggested by biochemical testing in blood and urine and confirmed by functional assays in cultured skin fibroblasts, followed by mutation analysis. This review describes the phenotype of the main peroxisomal disorders and possible pitfalls in (laboratory) diagnosis to aid clinicians in the recognition of this group of diseases. Georg Thieme Verlag KG Stuttgart · New York.
Holch, Julian Walter; Westphalen, Christoph Benedikt; Hiddemann, Wolfgang; Heinemann, Volker; Jung, Andreas; Metzeler, Klaus Hans
Recent developments in genomics allow a more and more comprehensive genetic analysis of human malignancies, and have sparked hopes that this will contribute to the development of novel targeted, effective and well-tolerated therapies.While targeted therapies have improved the prognosis of many cancer patients with certain tumor types, "precision oncology" also brings along new challenges. Highly personalized treatment strategies require new strategies for clinical trials and translation into routine clinical practice. We review the current technical approaches for "universal genetic testing" in cancer, and potential pitfalls in the interpretation of such data. We then provide an overview of the available evidence supporting treatment strategies based on extended genetic analysis. Based on the available data, we conclude that "precision oncology" approaches that go beyond the current standard of care should be pursued within the framework of an interdisciplinary "molecular tumor board", and preferably within clinical trials. © Georg Thieme Verlag KG Stuttgart · New York.
Brauer, H U; Walther, W; Dick, M
Legal expert opinions are a crucial instrument of professional self-control in medicine. To give impulses for further development, focus groups were initiated to reflect upon the perspective of legal dental experts. 5 focus group discussions on the topic "Professionalization of legal dental experts" were conducted. A total of 32 experienced legal dental experts participated in the discussions. The results were evaluated by qualitative content analysis. A catalogue of 68 ideas was generated for improvement and divided into 15 categories. Among these were periodic quality circles, interprofessional exchange, supervision of novices and periodic feedback for legal dental experts and dentists. Self-reflection can be included as an instrument for quality improvement of legal dental expert opinions. © Georg Thieme Verlag KG Stuttgart · New York.
Michelsen, K; Brand, H
The WHO Regional Committee for Europe agreed in September 2012 on the new framework strategy "Health 2020". The framework has the strategic objectives of improving health for all and reducing health inequalities as well as improving leadership and participatory governance for health. The present article introduces the basic points of "Health 2020". Central elements (European Action Plan for Strengthening Public Health and Public Health Services, health and well-being, reducing health inequalities, whole-of-governance and whole-of-society approaches) are described in more detail, taking background materials into account. Critical remarks address the implementation, reporting and governance issues. They are discussed by taking into account the context of the development of "Health 2020". Even if some critical aspects exist, it can be stated that "Health 2020" delivers a framework and orientation for health policies - as well as for the heterogeneous situation in WHO Europe as well as for Germany. © Georg Thieme Verlag KG Stuttgart · New York.
Spangenberg, Lena; Romppel, Matthias; Bormann, Bianca; Hofmeister, Dirk; Brähler, Elmar; Strauß, Bernhard
The Narcissistic Personality Inventory (NPI) is a commonly used measure of narcissism. This study administered a 15 item short version of the NPI (NPI-15). Central aims of the present study were to examine its dimensionality, and to provide data on its psychometric properties. NPI-15 and Hospital Anxiety and Depression Scale (HADS-D) were assessed in a representative sample of the German population (N=2,512). According to Scree-plot and model fit, a solution with 2 or 3 factors seemed feasible. Because of factor loadings and item-level associations to depression/anxiety we decided to favour a 2-factor-solution. 2 subscales reflecting different facets of narcissism were compiled (leadership ability/personality [LA/LP], grandiosity [G]). The psychometric properties of these scales were good (LA/LP) respectively unsatisfactory (G). The validity of the NPI-15 needs to be further studied. © Georg Thieme Verlag KG Stuttgart · New York.
Klopp, Michael; Hoffmann, Hans; Dienemann, Hendrik
A chest tube is used to drain the contents of the pleural space to reconstitute the physiologic pressures within the pleural space and to allow the lungs to fully expand. Indications for chest tube placement include pneumothorax, hemothorax, pleural effusion, pleural empyema, and major thoracic surgery. The most appropriate site for chest tube placement is the 4th or 5th intercostal space in the mid- or anterior- axillary line. Attention to technique in placing the chest tube is vital to avoid complications from the procedure. Applying the step-by-step technique presented, placement of a chest tube is a quick and safe procedure. Complications - frequently occurring when the tube is inserted with a steel trocar - include hemothorax, dislocation, lung lacerations, and injury to organs in the thoracic or abdominal cavity." © Georg Thieme Verlag KG Stuttgart · New York.
Ipekci, S H; Cakir, M; Kiyici, A; Koc, O; Artac, M
Radiation-induced hypopituitarism is an important late complication of cranial radiotherapy in children and adults. The purpose of this cross-sectional study was to evaluate the effects of radiotherapy on pituitary function in adult nasopharyngeal carcinoma patients. Pituitary function was evaluated in 30 patients after cranial radiotherapy for nasopharyngeal carcinoma. Somatotroph and corticotroph axes were assessed by insulin tolerance test while gonadotroph and thyroid axes were evaluated by basal pituitary and end organ hormone levels at 10-133 months after radiotherapy. At least one hormonal disorder was observed in 28 (93%) patients after radiotherapy. 26 (87%) patients had one or more anterior pituitary hormone deficiencies. The rates of pituitary hormone deficiencies were 77% for growth hormone, followed by adrenocorticotropic hormone (73%), thyroid-stimulating hormone (27%) and gonadotropins (7%). Hyperprolactinemia was present in 13 (43%) patients. Radiation-induced hypopituitarism is more common than expected in patients with nasopharyngeal carcinoma. © Georg Thieme Verlag KG Stuttgart · New York.
Menteşe, E; Yilmaz, F; Ülker, S; Kahveci, B
In this study, a new series of fluorine containing benzimidazoles (4a-l) and bisbenzimidazoles (6a-c, 8) were synthesized by the reaction of o-phenylenediamines with iminoester hydrochlorides (3a-l, 7) in methanol under microwave irradiation. The structures of these newly synthesized compounds were identified by IR, (1)H-NMR, (13)C-NMR, mass spectroscopy and elemental analysis data. The synthesized compounds were screened for their pancreatic lipase activities. Our results indicate that the compounds 6a, 6b and 6c can serve as an anti-lipase agent. The compounds 6b and 6c inhibited pancreatic lipase activity by 84.03% and 97.49% at a concentration of 3 µg/mL, respectively. © Georg Thieme Verlag KG Stuttgart · New York.
Kunzler, Angela; Skoluda, Nadine; Nater, Urs
In the face of demographic change, the informal care of dementia patients is becoming increasingly important. However, due to dementia symptoms as well as persisting care demands, this subgroup of informal caregivers is confronted with a large number of stressors resulting in chronic stress and impaired physical and mental health in many caregivers. Based on the current research on resilience (i. e., maintaining or regaining health despite stress and adversities), there is increasing interest in identifying resilience factors that may serve as resources to cope with informal care and protect caregivers against health problems. The review discusses the role of resilience factors in the association between ongoing caregiving stress and health. In analyzing the current state of research on resilience factors for dementia caregivers, we focus on the factors self-efficacy, relationship quality, and social support. © Georg Thieme Verlag KG Stuttgart · New York.
Vogelsang, H; Pfeiffer, J; Moser, G
Constipation is one of the most frequent gastroenterological problems, especially among elderly people. Chronic constipation is now defined by the new Rome III criteria. Life style counselling is usually only effective in early stages of disease and for mild types. In patients with constipation one should actively screen for possible causative, medically adverse events. Recently new effective opioid antagonists were introduced to act against constipation in patients on long-term opioid therapy. If these actions fail, medical therapy with polyethylene glycol or lactulose should be favoured in the long-term treatment. Psychodiagnostic queries concerning fear should be included in the diagnostic procedures. Biofeedback is an effective therapy in these cases and especially with pelvic floor dyssynergia. Surgical interventions are rarely indicated or successful with the exception of chronic outlet obstruction with severe anatomic changes. © Georg Thieme Verlag KG Stuttgart · New York.
Mills, D. L.; Avramovic, Z.
This first Quarterly Project Report on LINKABIT's contribution to the Defense Advanced Research Projects Agency (DARPA) Internet Program covers the period from 22 December 1982 through 21 March 1983. LINKABIT's support of the Internet Program is concentrated in the areas of protocol design, implementation, testing, and evaluation. In addition, LINKABIT staff are providing integration and support services for certain computer systems to be installed at DARPA sites in Washington, D.C., and Stuttgart, West Germany. During the period covered by this report, LINKABIT organized the project activities and established staff responsibilities. Several computers and peripheral devices were made available from Government sources for use in protocol development and network testing. Considerable time was devoted to installing this equipment, integrating the software, and testing it with the Internet system.
The systems approach to biology has a long history. Its recent rapid resurgence at the turn of the century reflects the problems encountered in interpreting the sequencing of the genome and the failure of that immense achievement to provide rapid and direct solutions to major multi-factorial diseases. This paper argues that systems biology is necessarily multilevel and that there is no privileged level of causality in biological systems. It is an approach rather than a separate discipline. Functionality arises from biological networks that interact with the genome, the environment and the phenotype. This view of biology is very different from the gene-centred views of neo-Darwinism and molecular biology. In neuroscience, the systems approach leads naturally to 2 important conclusions: first, that the idea of 'programs' in the brain is confusing, and second, that the self is better interpreted as a process than as an object. © Georg Thieme Verlag KG Stuttgart · New York.
Savinsky, Godo; Stuhr, Markus; Kappus, Stefan; Trümpler, Stefan; Wenderoth, Stephan; Wohlers, Jan-Hauke; Paschen, Hans-Richard; Kerner, Thoralf
Medical concepts and strategies are permanently changing. Due to the emergency response in a mass casualty incident everyone who is involved has to work together with different organisations and public authorities, which are not part of the regular emergency medical service. Within the last 25 years throughout the whole country of Germany the role of a "chief emergency physician" has been implemented and in preparation for the FIFA World Cup 2006 mobile treatment units were set up. In 2007, special units of the "Medical Task Force" - funded by the german state - were introduced and have been established by now. They will be a permanent part of regional plannings for mass casualty incidents. This article highlights current concepts and developments in different parts of Germany. © Georg Thieme Verlag Stuttgart · New York.
Enders, P; Schaub, F; Fauser, S
Background Laser therapy is an important treatment option in retinal diseases, especially in cases of vascular involvement. Most approaches are based on coagulation of retinal structures. As there is increasing use of agents targetting vascular endothelial growth factor in the treatment of macular diseases, indications for the use of laser treatment need to be reviewed carefully, especially with respect to their significance in first line therapy. This article explains recent strategies and treatment protocols. Materials and Methods Review of current literature in PubMed as well as synopsis of relevant guidelines. Results and Conclusion Retinal laser therapy is still widely used within retinal opthalmology and covers a large spectrum of indications. Despite the success of medical approaches, retinal laser therapy remains an indispensable treatment option for proliferative diabetic retinopathy, central or peripheral vein occlusion and less frequent pathologies, such as retinopathy of prematurity or Coats's disease. Georg Thieme Verlag KG Stuttgart · New York.
Grafarend, E. W.; Ardalan, A.; Finn, G.
In terms of elliptic coordinates of Jacobi type (longitude, latitude, semi-minor axis) the horizontal derivative is computed as a linear operator acting on an ellipsoidal har- monic disturbing/incremental gravitational potential. Such disturbing potential is de- fined with respect to the Somigliana-Pizzetti Reference Potential, the potential field of a level ellipsoid, and the International Reference Ellipsoid/WGS84 or World Geode- tic Datum 2000/WGD2000. Case studies of those vertical deflections on a global as well as regional scale are presented which take advantage of SEGEN (Special Ellipsoidal Gravity Earth Normal: ellipsoidal harmonics expansion 130321 coeffi- cients: http://www.uni-stuttgart.de/gi/research/paper/coefficients/coefficients.zip) and of CENT (precise centrifugal potential)
Dietrich, S; Stengler, K
This work is aimed at providing a review of the literature on gender differences in the prevalence of mental disorders at the workplace. A systematic literature search of all original works on sickness absence and disability due to psychiatric disorders published in PubMed from 2000 through to 2011 was undertaken. Female employees have more frequent and longer sickness absences due to psychiatric disorders. Male employees are at a high risk of disability due to psychiatric disorders. Gender-specific prevention strategies at the workplace should target the prevention of short and long-term consequences for female employees and the long-term impact of psychiatric disorders in male employees. However, there is still a lack of knowledge about implications for gender specific prevention strategies at the workplace. © Georg Thieme Verlag KG Stuttgart · New York.
Jäger, M; Becker, T; Wigand, M E
Against the background of Max Weber's and Karl Jaspers' outstanding historical contributions to the conceptual development of different typologies, the importance of a psychiatric typology is examined. The term "ideal type" was introduced into social science by Weber as an analytical construct to describe and classify cultural phenomena. This concept was adopted for the psychiatric context by Jaspers who proposed to establish a typological system in the field of psychotic disturbances without an organic correlate. He emphasized the importance of the course of psychopathological symptoms for such a typological system. The concept of typology can be regarded as a promising heuristic approach in psychiatry, providing a classification system for complex psychopathological symptoms. Even though several historic typologies exist in psychopathology, their usefulness in the fields of therapy and prognosis needs to be critically assessed. Also, new typologies will have to be developed, taking into account neurobiological knowledge now available. © Georg Thieme Verlag KG Stuttgart · New York.
Krstić, V.; Rikken, G. L. J. A.
The free electron on a helix as a simple model of a molecular chiral conductor is considered. In the presence of a static magnetic field parallel to the helix axis, it is found that both ballistic and diffusive electrical transport along the helix show a conductivity that depends linearly on the current and the magnetic field and on the handedness of the helix. These results agree qualitatively with the recently experimentally observed electrical magneto-chiral anisotropy in carbon nanotubes [V. Krstić, S. Roth, M. Burghard, K. Kern, G.L.J.A. Rikken, Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany; Grenoble High Magnetic Field Laboratory, MPI-CNRS, Grenoble, France; Laboratoire National des Champs Magnétiques Pulsés, CNRS/INSA/UPS, UMS 5462, Toulouse, France].
Gumz, Antje; Erices, Rainer; Brähler, Elmar; Zenger, Markus
The Maslach Burnout Inventory (MBI) is the most commonly used instrument in research on burnout. For the German translation of the MBI student version (MBI-SS), the postulated 3-factorial structure of the questionnaire could be confirmed using confirmatory analyses. The internal consistencies of the scales can be classified as good. First findings underline the construct validity of the questionnaire. As expected, burnout was associated with psychic and somatic complaints as well as with experienced social support. Couples reported higher "Efficiency" levels. Academic studies became less important with increasing duration. Time pressure during the last month was correlated with "Exhaustion". The presented findings on factorial structure and validity speak for the applicability of MBI-SS for research projects on students of German institutes of higher education. © Georg Thieme Verlag KG Stuttgart · New York.
Sun, Yan-Jun; Li, Zhan-Lin; Chen, Hong; Liu, Xiao-Qiu; Zhou, Wei; Hua, Hui-Ming
Four new tetrahydrofuranoid lignans, (-)-tanegool-7'-methyl ether ( 1), (+)-7'-methoxylariciresinol (2), sinolignan C (3), and epipinoresinol-4,4'-di- O- β- D-glucopyranoside (4), were isolated from the roots and rhizomes of SINOPODOPHYLLUM EMODI together with one known lignan (5). Their structures and stereochemistry were elucidated on the basis of spectroscopic and mass spectrometric evidence. The isolation of compounds 1- 5 represents the first report of tetrahydrofuran lignans from the genus SINOPODOPHYLLUM. The cytotoxic activities of all isolated compounds were evaluated against HeLa and KB cell lines, and compound 1 showed the most potent cytotoxicity with IC₅₀ values of 9.7 µM and 4.7 µM, respectively. © Georg Thieme Verlag KG Stuttgart · New York.
Cheng, B; Pan, S; Liu, X; Zhang, S; Sun, X
Diabetes mellitus may result in taste disturbance. The present study has revealed that cell apoptosis of taste buds in circumvallate papillae may contribute to the taste disturbance in a rat model of type2 diabetes. Type2 diabetes was induced in Wistar rats by feeding them with a high-fat diet (30% fat), and a single intraperitoneal injection of streptozotocin (30 mg/kg). The increased cell apoptosis of taste buds in circumvallate papilla sections was detected by TUNEL staining in diabetic rats, and the ultrastructure was further examined by transmission electronic microscopy. Immunohistochemical and Western blot analyses revealed the downregulation of Bcl-2, upregulation of Bax, and increased activation of caspase-9 and -3, in diabetic rats, indicating that the apoptosis of taste bud cells may be mediated via the intrinsic mitochondrial pathway in diabetics. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.
Jungbauer, J; Ehlen, S
This article presents results from a study of 834 nursery school teachers in Germany, investigating working conditions, stress, and stress-related health problems. In order to evaluate the extent of mental and psychosomatic troubles, as well as the risk of burnout, we used the standardised questionnaire "Burnout Screening Scales" (BOSS I). Data analysis yielded a high percentage of nursery school teachers who reported a remarkably high stress level; nearly 20% can be considered as a high-risk group for burnout. Poor staff conditions in many nurseries turned out to be the crucial stress source, along with large groups, insufficient teacher-child ratio, time pressure and multitasking. In the concluding discussion of the study results, we consider possible measures to reduce stress and to improve working conditions for nursery school teachers. © Georg Thieme Verlag KG Stuttgart · New York.
Etzersdorfer, Elmar; Schäfer, Monika; Becker-Pfaff, Johannes
The case of a mentally disturbed young man is described, whose identity could not be revealed over more than four months. It is compared to Kaspar Hauser, similarities and differences are highlighted. The "Kaspar Hauser of Stuttgart" is retrospectively revealed as a young man with experiences of severe deprivation. The missing case history and independent history were an obstacle in the treatment, albeit not fundamental, advantages being reached with a relation-oriented approach. Informations obtained after clarification of the identity of the young man suggest a multiplication of unfavourable circumstances, leading to sub-optimal treatment and finally the "Kaspar-Hauser-Situation". Contributing were his belonging to the less integrated group of migrants in Germany, as well as severe deprivation in the family and a generally sub-optimal treatment of mentally disturbed young patients.
Grätz, Juliane; Brieger, Peter
To study effects of the implementation of joint-crisis plans (JCP) on health-care users and professionals. The first 3 years of the implementation of JCP were followed with structured interviews with health-care users and professionals. Legal and administrative complications were documented. 36 of 44 subjects with JCP were assessed. Most of them had learned of JCP through other users or self-help. 55 % had prior experience with compulsory treatment. Better communication and self-determination were main goals of JCP. A relevant change in hospital treatment through JCP was not observed. Only few professionals had made direct experience with JCP. They valued JCP mildly positive. No legal and administrative complications were documented. Only a small minority of users signed JCP. JCP were easily employed and improved communication and self-determination. © Georg Thieme Verlag KG Stuttgart · New York.
von Roth, Philipp; Wassilew, Georgi I
Extra-large uncemented jumbo cups are among the most common methods of acetabular revision. Jumbo cups do not contribute to bone stock restoration, and in the case of a subsequent revision, an even larger bone defect is to be expected. Thus, understanding long-term survival is essential. The present article discusses the literature relevant to this topic and addresses technical and implant-specific characteristics of jumbo cups. In summary, jumbo cups show an acceptable long-term survival rate, with aseptic loosening as the most common reason for revision and dislocation being the most common complication. Through the development of alternative revision systems, jumbo cups have lost their importance in today's practice. However, they can serve as a benchmark for studies of newer technologies in revision total hip arthroplasty. Georg Thieme Verlag KG Stuttgart · New York.
Hoffmann, H; Gompelmann, D; Heußel, C P; Dienemann, H; Eberhardt, R
Patients with diffuse airway instability due to tracheobronchomalacia or excessive dynamic airway collapse are typically highly symptomatic, with marked dyspnoea, recurrent bronchopulmonary infections and excruciating intractable cough. Silicone stents achieve immediate symptom control, but are - due to the typical complications associated with stent treatment - usually not an option for long-term treatment. The aim of surgical intervention is definitive stabilisation of the trachea and of both main bronchi by posterior splinting of the Paries membranaceus with a polypropylene mesh. This operation is an appropriate treatment option for patients with documented severe tracheobronchomalacia or excessive dynamic airway collapse and is ultimately the only therapy that can achieve permanent symptom control. The success of the operation, however, depends on many factors and requires close interdisciplinary collaboration. Georg Thieme Verlag KG Stuttgart · New York.
Schag, Kathrin; Leehr, Elisabeth J; Skoda, Eva-Maria; Becker, Sandra; Zipfel, Stephan; Giel, Katrin E
Binge Eating Disorder (BED) is an eating disorder where cognitive behavioural therapy (CBT) could already show reliable efficacy. Relying on basic research, CBT interventions which especially focus on impulsivity could be effective, because binge eating episodes represent highly impulsive eating behaviour. For this reason, we developed a treatment concept about an impulsivity-focused behavioural group intervention for patients with BED, called IMPULS. The efficacy of IMPULS is currently investigated in a randomised controlled trial 1. IMPULS is drafted as a weekly group training programme with 5-6 participants per group. The essential interventions are food-related cue exposure with response prevention and the development of self-control strategies. These interventions are adapted onto the impulsivity concept from conventional treatment of addictive disorders and BED. © Georg Thieme Verlag KG Stuttgart · New York.
Holzapfel, C; Hauner, H
Mean weight loss of most conservative therapeutic weight loss programmes is about five to six kilograms after one year. In our "obesogenic" environment it is difficult for persons to maintain the new weight. Also continuation of the programme cannot prevent a moderate weight increase in the follow-up year. The reasons for this are not clear: individual lifestyle, environmental and genetic factors may play a role, but also the complex regulatory system of the body "to defend its weight". Nevertheless, for weight maintenance a lifelong change of lifestyle is of critical importance. Concerning nutrition a fat-reduced diet with a decrease of energy density together with regular eating habits and adequate portion size promises the greatest benefit and is likely to allow sufficient satiety. © Georg Thieme Verlag KG Stuttgart · New York.
Prevedel, Bernhard; Martens, Sonja; Norden, Ben; ...
At Ketzin, located west of Berlin, the GFZ German Centre for Geosciences is operating Europe's largest CO₂ research storage site. This pilot site has been developed since 2004 and is comprised of one combined injection/observation well and four monitoring wells. From June 2008 to August 2013, a total of 67 kilotons of CO₂ were safely injected into the sandstone units of the Upper Triassic Stuttgart Formation in a depth between 630 to 650 m. The paper discusses the well designs and lessons learned in drilling engineering and operations. The abandonment phase started in Ketzin with the first plug cementation ofmore » the observation well Ktzi 202 shortly after shut-in of CO₂ injection. The experience with the first CO₂ well killing operation will be reviewed.« less
Rabenschlag, Franziska; Steinauer, Regine; Heimann, Regine; Reiter-Theil, Stella
Research on staff perception of ethical aspects of psychiatric patient care are scarce; little is known about systematic supplies of ethics support in psychiatric institutions. The goal of this pilot study is to inform the implementation of Clinical Ethics Support Services in psychiatric institutions by assessing which topics of psychiatric practice are considered ethically challenging by the staff. Explorative survey as pilot study by questionnaire with clinical staff, quantitative (descriptive) and qualitative (coding) data-analysis. Involuntary treatment, the relationship between healthcare professionals and patients, staff shortage and the collaboration between the professions as well as dealing with patient relatives came up as ethical challenges. Clinical Ethics Support in psychiatric patient care should not only cover aspects that are specific for psychiatry, but also structural topics such as short resources, interprofessional collaboration and communication with relatives. © Georg Thieme Verlag KG Stuttgart · New York.
Arsalan-Werner, A; Mentzel, T; Kempf, B; Sauerbier, M
Hidradenocarcinomas are rare, yet highly malignant tumors of eccrine sweat gland origin. Due to its locally aggressive growth and likelihood for metastasis it should be considered as a differential diagnosis especially in case of suspicious intraoperative findings. We report the case of a 73-year-old female patient presenting with a hidradenocarcinoma of the wrist. Treatment of hidradenocarcinomas is similar to the treatment of sarcomas: The first step is an incisional biopsy and obtaining an expert second opinion on the histopathological diagnosis as well as staging. The second step is a clear margin resection of the tumor and the plastic-surgical reconstruction. A long-term follow-up is mandatory to detect potential recurrence or metastasis. © Georg Thieme Verlag KG Stuttgart · New York.
Slesak, Günther; Gabriel, Martin; Domingo, Cristina; Schäfer, Johannes
History and physical examination A 56-year-old man developed high fever with severe headaches, fatigue, impaired concentration skills, and an exanthema 5 days after a yellow fever (YF) vaccination. Laboratory tests Liver enzymes and YF antibody titers were remarkably elevated. YF vaccine virus was detected in urine by PCR. Diagnosis and therapy Initially, severe YF vaccine-associated visceral disease was suspected and treated symptomatically. Clinical Course His fever ceased after 10 days in total, no organ failure developed. However, postencephalitic symptoms persisted with fatigue and impaired concentration, memory, and reading skills and partly incapability to work for over 3 months. A diagnosis was made of suspected YF vaccine-associated neurotropic disease. Conclusion Severe vaccine-derived adverse effects need to be considered in the indication process for YF vaccination. © Georg Thieme Verlag KG Stuttgart · New York.
Jordan, Wolfgang; Adler, Lothar; Bleich, Stefan; Cohrs, Stefan; von Einsiedel, Regina; Falkai, Peter; Grosskopf, Volker; Hauth, Iris; Steiner, Johann
Current psychiatric-psychotherapeutic in-patient care takes place in an area of tension between increasing treatment requirements and the persistent lack of qualified staff. The optimisation of the diagnostic-therapeutic procedures in a clinic helps to reduce existing care deficits or to generate resources for future developments. The subject of delegation and substitution of medical services is considered in this context. Inadequate knowledge of the legal situation on the part of the decision makers impairs the indispensable trustful cooperation among the professions and adds to the uncertainty of all those concerned. The present paper outlines the legal, organisational and health policy aspects of delegation and the reorganisation of medical activities in the field of psychiatry. © Georg Thieme Verlag KG Stuttgart · New York.
Nitzsche, A; Driller, E; Kowalski, C; Ansmann, L; Pfaff, H
This study investigates the conflict between work and private life (work-life conflict and life-work conflict) and its relationship with burnout among physicians in breast cancer centers in North Rhine-Westphalia (n=378). With regard to the construct burnout, we differentiated between the 3 subscales emotional exhaustion, depersonalisation and personal accomplishment of the Maslach burnout inventory. In a structural equation model it was seen that above all the work-life conflict is positively associated with emotional exhaustion whereas the life-work conflict has a stronger positive correlation with depersonalisation and a negative relationship with personal accomplishment. Altogether, the results emphasise the importance of a successful interaction between professional work and private life ("work-life balance") for the health of medical personnel. © Georg Thieme Verlag KG Stuttgart · New York.
Fontenelle, L C; Feitosa, M M; Severo, J S; Freitas, T E C; Morais, J B S; Torres-Leal, F L; Henriques, G S; do Nascimento Marreiro, D
Obesity is associated with several metabolic and endocrine disorders; and changes in plasma concentrations, secretion patterns, and clearance of various hormones are observed in obese patients. In this context, recent research has shown that overweight can influence the function of the thyroid gland, usually leading to increased thyrotropin concentrations and changes in the ratio between the hormones triiodothyronine and thyroxine, though within the normal range. The etiology of these changes is still unclear; however, several mechanisms have been proposed including the adaptive process to increase energy expenditure, hyperleptinemia, changes in the activity of deiodinases, the presence of thyroid hormones resistance, chronic low-grade inflammation, and insulin resistance. Although the clinical implications have not been clarified, studies suggest that these changes in the thyroid function of obese individuals may contribute to the worsening of metabolic complications and the development of diseases in the thyroid gland. © Georg Thieme Verlag KG Stuttgart · New York.
Schröter, A; Riha, O; Steinberg, H
At the beginning of the 19 (th) century German scholars wanted to differentiate men and women on the basis of anatomic brain or cerebrum particularities. With the help of scientific criteria such as the weight of the brain they aimed not only to prove pre-postulated intellectual differences, but also to find scientific justification for the inferiority of women in general and their inferior position and treatment in society. This paper presents insights into and excerpts from studies written by renowned scientists such as S. T. von Soemmerring, J. F. Ackermann, K. F. Burdach, F. Tiedemann, E. Huschke, H. Schaaffhausen, or P. J. Möbius. Covering the years from 1780 to 1900, these materials show how at the beginning the interest was primarily in comparative anatomic studies and results, but was soon mingled with sociological intentions. Hence this study gives insights into the history of modern gender studies of neurosciences. © Georg Thieme Verlag KG Stuttgart · New York.
Thelen, P; Taubert, H; Duensing, S; Kristiansen, G; Merseburger, A S; Cronauer, M V
A recently discovered mechanism enabling prostate cancer cells to escape the effects of endocrine therapies consists in the synthesis of C-terminally truncated, constitutively active androgen receptor (AR) splice variants (AR-V). Devoid of a functional C-terminal hormone/ligand binding domain, various AR-Vs are insensitive to therapies targeting the androgen/AR signalling axis. Preliminary studies suggest that AR-V7, the most common AR-V, is a promising predictive tumour marker and a relevant selection marker for the treatment of advanced prostate cancer. This review critically outlines recent advances in AR-V7 diagnostics and presents an overview of current AR-V7 targeted therapies. © Georg Thieme Verlag KG Stuttgart · New York.
Wanke, Eileen M; Exner-Grave, Elisabeth
Training with pointe shoes is an integral part of professional dance education and ambitious hobby dancing. Pointe shoes - developed more than hundred years ago and almost unaltered since then - are highly specific and strike a balance between aesthetics, function, protection, and health care. Therefore, pointe readiness should be tested prior to all dance training or career training. Medical specialists are often confronted with this issue. Specific anatomical dance technique-orientated general conditional and coordinative preconditions as well as dance-technical prerequisites must be met by pointe readiness tests in order to keep traumatic injuries or long-term damage at a minimum. In addition to a (training) history, medical counselling sessions have come to include various tests that enable a reliable decision for or against pointe work. This article suggests adequate testing procedures (STT TEST), taking account of professional dancing as well as hobby dancing. © Georg Thieme Verlag KG Stuttgart · New York.
Kinoshita, K; Kawai, T; Imaizumi, T; Akita, Y; Koyama, K; Takahashi, K
The anti-emetic effects of 40 extracts made from 12 traditional Chinese herbal drugs were examined. Ten extracts inhibited emesis induced by copper sulfate pentahydrate; all were administered orally, and one extract inhibited emesis induced by apomorphine hydrochloride given to leopard and ranid frogs. Taraxasteryl palmitate and acetate, bigelovin and dihydrobigelovin were isolated from the CHCl(3) extract of Inula linariaefolia flowers, and identified as the active antiemetic agents when emesis was induced by copper sulfate. In addition, chlorogenic acid was isolated from the MeOH extract as an anti-emetic principle for the emesis induced by apomorphine hydrochloride. Rengyol, phillyrin and rutin were isolated from the MeOH extract of Forsythia suspensa fruits and identified as the inhibitors of emesis induced by copper sulfate pentahydrate. Copyright © 1996 Gustav Fischer Verlag · Stuttgart · Jena · New York. Published by Elsevier GmbH.. All rights reserved.
Frietsch, Thomas; Schuler, Matthias; Adler, Georg
The aging society challenges anaesthesiologists with a growing number of patients with dementia. These and their relatives worry about an aggravation of an already existing dementia or even the postoperative evocation of one. Common volatile anaesthetics and propofol are suspected to increase dementia - associated protein tau and amyloid-betalevels in the brain. Perioperative complications such as cognitive dysfunction and delirium occur more frequently in dementia patients. For anaesthesiologists, it seems prudent toassess the grade of dementia in the elderly to adjust anaesthesia drug doses and monitoring intra- and postoperatively. Pharmacological interactions with antidementic andneuroleptic current medications affectanaesthetic and analgesic effects.In dementia, perioperative malfunction of cognition, memory, attention, information processing, communication and social interaction abilities is of profound influence on the perioperative management.This review mentions actual knowledge about dementia forms and symptoms in brief. Recommendations for the anaesthesia care are given in more detail. © Georg Thieme Verlag Stuttgart · New York.
Kumbier, Ekkehardt; Haack, Kathleen; Steinberg, Holger
The so-called Rodewisch Theses of 1963 demonstrate East German psychiatry's attempts to implement social-psychiatric reforms. To mark their 50th anniversary, this article analyses their emergence, drafting and implementation. It has been known that key requirements could only be fulfilled on a regional basis, the Leipzig University Department of Psychiatry being an outstanding example, although its staff worked rather autonomously of the Rodewisch Theses. The reasons for the different degree of success of these developments in individual areas are manifold, key reasons being the lack of stark political support and of opportunity to discuss shortcomings in mental health care, as in Western Germany, due to political circumstances in particular. There was no strong social basis and support as in Western democracies. © Georg Thieme Verlag KG Stuttgart · New York.
Scholz, Michael; Neumann, Carolin; Steinmann, Cornelia; Hammer, Christian M; Schröder, Antje; Eßel, Nicole; Paulsen, Friedrich; Burger, Pascal H M
Symptoms of burnout are common among medical students. Although they usually start with a good health status, their condition deteriorates over the course of their studies. In our study ESTRELLAS we examined 530 medical students in the preclinical semesters with validated psychological questionnaires. The longer the students were studying, the more showed risky working habits. Cognitive and emotional burnout symptoms increased coincidentally in their intensity, whereas the mental quality of life continuously deteriorated. Medical students' cognitive and emotional burnout symptoms are constantly increasing from the beginning of their studies. Contemporaneously, the mental quality of life is deteriorating. This might be based on a drastic change towards risky working habits. We suggest to actively work against this process to keep our motivated students and prospective physicians productive and in good mental health. © Georg Thieme Verlag KG Stuttgart · New York.
Stickel, N; Zeiser, R
Immunoregulation following allogeneic hematopoietic stem cell transplantation (allo-HSCT) involves the delicate balance between the desirable graft-versus-leukemia (GvL) effect and the prevention of the undesirable graft-versus-host disease (GvHD). Emerging evidence has shown that microRNAs (miRNAs) play a role in the pathogenesis of different inflammatory and malignant diseases. Especially in autoimmune diseases, allergy and GvHD numerous dysregulated miRNAs have been identified. In this review, we provide an overview of current knowledge about the role of miRNAs in the immunoregulation after allo-HSCT. Moreover, we give an outlook on potential new diagnostic and therapeutic approaches, including the use of miRNAs as clinical biomarkers and the manipulation of immune responses using miRNA mimetics. © Georg Thieme Verlag KG Stuttgart · New York.
Erlmeier, F; Weichert, W; Autenrieth, M; Ivanyi, P; Hartmann, A; Steffens, S
c-Met plays a significant role in multiple cellular processes. Being encoded by a proto-oncogene, tyrosine kinase supports aggressive tumour behaviour such as tumour invasiveness and formation of metastases. For some subtypes of renal cell carcinoma studies have shown a association between c-Met expression and clinical outcome or prognosis. Therefore, c-Met represents a prognostic marker in renal cell carcinoma.Furthermore, c-MET will play a decisive role as a possible target for targeted therapies in the era of personalised medicine. Especially for RCC, the dual inhibition of VEGF and c-MET tyrosine kinase in cases of metastatic, treatment-resistant tumours is gaining clinical relevance. The role of c-Met has not been fully elucidated for all subtypes of renal cell carcinomas. The relevance of c-Met for the remaining subtypes of renal tumours has yet to be clarified. © Georg Thieme Verlag KG Stuttgart · New York.
Dexl, A K
The determination of reading acuity is still the most important clinical examination, whenever the potential benefits of "presbyopic surgery" are compared. Reading distance--the by far most critical parameter in testing reading acuity--seems to be quite variable for every patient tested, whenever patients are allowed to freely choose a subjectively convenient reading distance. Therefore, measuring reading acuity with a fixed reading distance does not allow conclusions to be drawn on the "every-day reading ability" of individual patients. Since 2004, the Eye Clinic of Salzburg University has been continuously working on the development of a standardised device that enables clinicians and researchers to systematically evaluate every patient's individual reading performance under standardised conditions. © Georg Thieme Verlag KG Stuttgart · New York.
Gläser, S; Ittermann, T; Schäper, C; Obst, A; Dörr, M; Spielhagen, T; Felix, S B; Völzke, H; Bollmann, T; Opitz, C F; Warnke, C; Koch, B; Ewert, R
The interpretation of gas exchange measured by cardiopulmonary exercise testing (CPET) depends on reliable reference values. Within the population based Study of Health in Pomerania (SHIP) CPET was assessed in 1706 volunteers. The assessment based on symptom limited exercise tests on a bicycle in a sitting position according to a modified Jones protocol. CPET was embedded in an extensive examination program. After the exclusion of active smokers and volunteers with evidence of cardiopulmonary and musculoskeletal disorders the reference population comprised 616 healthy subjects (333 women) aged 25 to 85 years. Reference equations including upper and/or lower limits based on quantile regression were assessed. All values were corrected for the most important influencing factors.This study provides reference equations for gas exchange and exercise capacity assessed within a population in Germany. © Georg Thieme Verlag KG Stuttgart · New York.
Schöpper, Christa; Venherm, Stefan; Van Aken, Hugo; Ellermann, Ines; Steinbicker, Andrea
The anesthesia preoperative evaluation has been developed in recent years in a centralized clinic, that can be visited by the majority of patients, in order to evaluate and obtain patient's consent for anesthesia. In the current article, the organization and structure of such a central anesthesia preoperative evaluation clinic in the Department of Anesthesia, Intensive Care and Pain Medicine at the University Hospital of Muenster, is described. Besides the central preoperative evaluation clinic, 3 clinics are localized in separate buildings and preoperative visits have to be completed in special scenarios on the wards, too. A pharmaceutical evaluation for patient's medication and the patient blood management have been integrated into the anesthesia preoperative evaluation clinic. Processes are explained and current numbers of patients are mentioned. © Georg Thieme Verlag Stuttgart · New York.
De Marino, Simona; Cattaneo, Fabio; Festa, Carmen; Zollo, Franco; Iaccio, Annalisa; Ammendola, Rosario; Incollingo, Filomena; Iorizzi, Maria
Imbricatolic acid was isolated from the methanolic extract of the fresh ripe berries of Juniperus communis (Cupressaceae) together with sixteen known compounds and a new dihydrobenzofuran lignan glycoside named juniperoside A. Their structures were determined by spectroscopic methods and by comparison with the spectral data reported in literature. Imbricatolic acid was evaluated for its ability to prevent cell cycle progression in p53-null CaLu-6 cells. This compound induces the upregulation of cyclin-dependent kinase inhibitors and their accumulation in the G1 phase of the cell cycle, as well as the degradation of cyclins A, D1, and E1. Furthermore, no significant imbricatolic acid-induced apoptosis was observed. Therefore, this plant-derived compound may play a role in the control of cell cycle. © Georg Thieme Verlag KG Stuttgart · New York.
Heusinger, J; Kammerer, K; Wolter, B; Schuster, M
Between 2007 and 2010 the Institut für Gerontologische Forschung e.V. investigated the "Primary Prevention Effects of the Märkisches Viertel Network" in the Berlin district "Märkisches Viertel". The study integrates, amongst others, various participatory methods to investigate the health promotion effects of the volunteer Märkisches Viertel Network, an organisation that brings together different local actors working to assist and encourage older people to live independent lives. Sustained active collaboration by a heterogeneous mixture of actors in a spatially defined quarter, engagement by the local housing association, and increasing acknowledgement of and participation by older residents were identified as success factors for a change in local structures. © Georg Thieme Verlag KG Stuttgart · New York.
Schwarz, Betje; Specht, Timo; Bethge, Matthias
Purpose To explore the patient's perspective on the involvement of employers into rehabilitation. Methods 8 participants of a work-related medical rehabilitation were interviewed by telephone 4 weeks after discharge. Qualitative content analysis was used to analyze generated data. Results Beside a poor employer-involvement, the interviews revealed that the process of returning to work was characterized and hampered by unused measures of supporting vocational reintegration during rehabilitation, intersection problems in the health care and social security system, and a strategy of waiting by all involved actors. Conclusion Beside an improved employer-involvement, systematic intersection management and full usage of existing measures are demanded to support vocational reintegration. © Georg Thieme Verlag KG Stuttgart · New York.
Schulz-Behrendt, C; Salzwedel, A; Rabe, S; Ortmann, K; Völler, H
This study investigated subjective biopsychosocial effects of coronary heart disease (CHD), coping strategies and social support in patients undergoing cardiac rehabilitation (CR) and having extensive work-related problems. A qualitative investigation was performed in 17 patients (48.9±7.0 y, 13 male) with extensive work-related problems (SIMBO-C>30). All patients were interviewed with structured surveys. Data analysis was performed using a software that is based on the content analysis approach of Mayring. In regard to effects of disease, patients indicated social aspects including occupational aspects (62%) more often than physical or mental factors (9 or 29%). Applied coping strategies and support services are mainly focused on physical impairments (70 or 45%). The development of appropriate coping strategies was insufficient although social effects of disease were subjectively meaningful for patients in CR. © Georg Thieme Verlag KG Stuttgart · New York.
Eichhorn, M E; Hoffmann, H; Dienemann, H
Pulmonary cystic echinococcosis is a very rare disease in Germany. It is caused by the larvae of the dog tapeworm (echinococcus granulosus). The liver is the most affected organ, followed by the lungs. Surgery remains the main therapeutic approach for pulmonary CE. Whenever possible, parenchyma-preserving lung surgery should be preferred over anatomic lung resections. To ensure best therapeutic results, surgery needs to be performed under precise consideration of important infectiological aspects and patients should be treated in specialised centres based on interdisciplinary consensus. In addition to surgical aspects, this review summarises special infectiological features of this disease, which are crucial to the surgical approach. Georg Thieme Verlag KG Stuttgart · New York.
Blind and visually impaired people experience special risks and hazards in road traffic. This refers to participation as a driver, bicycle rider and pedestrian. These risks are shown by a review of international research studies and a study by the author, where 45 people with Usher syndrome were asked about their accident rates and causes as driver, bicycle rider and pedestrian. In addition, basic legal information has been worked out to demonstrate the visual conditions of people with visual impairment for participation in road traffic. The research studies show that blind and visually impaired persons are particularly exposed to experience high risks in traffic. These risks can be reduced through acquisition of skills and coping strategies such as training in orientation and mobility. People with visual impairment need special programmes which help to reduce traffic hazards. Georg Thieme Verlag KG Stuttgart · New York.
Pabón, Adriana; Ramirez, Otoniel; Ríos, Alexandra; López, Ena; de Las Salas, Briegel; Cardona, Felipe; Blair, Silvia
The in vitro antiplasmodial activity of 122 raw extracts prepared in ethanol and water from 35 medicinal plants reported by the Cubeo indigenous village of the Amazon region (Vaupés Medio in Colombia) was evaluated for efficacy against 3D7 (sensitive to chloroquine) and FCR-3 (resistant to chloroquine) Plasmodium falciparum strains. Five percent of these extracts presented a significant antiplasmodial activity (< 5 µg/mL) and 83 % of them were not cytotoxic. These findings highlight the importance of investigating traditional medicinal plants implemented by these ancestral communities of the Amazon region as well as their potential to become a source of new drugs against malaria. Georg Thieme Verlag KG Stuttgart · New York.
Hamann, Johannes; Mendel, Rosmarie; Kissling, Werner
To assess the views of employees (human resource, works council, supervisors, and executives) of German business companies and administrations toward the issue of mental health at the workplace. Cross sectional survey of N = 348 employees with staff responsibility. Employees of German companies see their colleagues as moderately mentally stressed. About 14 % of all employees are judged to suffer from a mental disease. These numbers have risen in recent years. About 37 % of all mental illnesses are seen as caused by work conditions. The handling of mental illness at the workplace is seen as insufficient and in many cases stigmatizing. At least subjectively the issue of mental illness in the workplace has gained in importance in recent years. Possible interventions should especially address executives and supervisors. © Georg Thieme Verlag KG Stuttgart · New York.
Winter, Lotta; Kraft, Julia; Boss, Katharina; Kahl, Kai G
Psychiatric disorders, in particular depression and anxiety disorders, are important causes of impaired job performance and increased sick leave. Longer periods of sickness leave lead regularly to difficulties concerning return to work. Furthermore, work is an important factor for psychological health. The central issue of the "return to work" (RTW) module by Lagerveldt and colleagues 5 is remission from psychiatric disorder, and structured support to return to work. The module is based on principles of cognitive-behavioral therapy (CBT), and can be integrated in standard CBT. Existing data from a randomized controlled trial suggest that treatment outcome concerning remission is similar between CBT supplemented with RTW (CBT-W) module and standard CBT. However, time to return to work is reduced in CBT-W. © Georg Thieme Verlag KG Stuttgart Â· New York.
Vagts, Dierk A
The economical pressure on the health system and especially on hospitals is growing rapidly. Hence, economical knowledge for people in medical executive positions becomes imperative. In advanced and forward-looking hospitals controlling is gaining more and more weight, because it takes over a coordinative responsibility. Ideally controlling is navigating the teamwork of managers (CEOs) and medical executives by weighing medical necessities and economical framework. Controlling is contributing to evaluate an optimal efficiency of a hospital in a highly competitive surrounding by providing medical and economical data on a regular basis. A close, open-minded and trusting cooperation between all people, who are involved, is imperative. Hence, controlling in the proper meaning of the word can not flourish in dominant and hierarchic hospital structures. Georg Thieme Verlag Stuttgart * New York.
Schmid, Petra; Widmann, Bernhard; Jekel, Achim; Nelles, Ulrike; Fritschi, Thomas; Uhlmann, Carmen
Objective: In the treatment of patients with alcohol dependence it is next to physical detoxification under protected conditions to promoting abstinence motivation. Further the need of crisis interventions is derived from the clinical practise. To be able to become fairer to all groups of treatment as well as the different demands, the addiction admission station was restructured. Methods: Pre-post-evaluation. Results: It was found that the door was closed up significantly less often after the restructuring. In the residence time structure an increase appeared in the descriptive values with the more than 7-day stays. Conclusions: It is to be able to hold successfully the optional closed door highly significantly more often open. © Georg Thieme Verlag KG Stuttgart · New York.
Bisogno, G; Ferrari, A; Bien, E; Brecht, I B; Brennan, B; Cecchetto, G; Godzinski, J; Orbach, D; Reguerre, Y; Stachowicz-Stencel, T; Schneider, D T
The low incidence and the heterogeneity of very rare tumors (VRTs) demand for international cooperation. In 2008, EXPeRT (European Cooperative Study Group for Pediatric Rare Tumors) was founded by national groups from Italy, France, United Kingdom, Poland and Germany. The first aims of EXPeRT were to agree on a uniform definition of VRTs and to develop the currently most relevant scientific questions. Current initiatives include international data exchange, retrospective and prospective studies of specific entities, and the development of harmonized and internationally recognized guidelines. Moreover, EXPeRT established a network for expert consultation to assist in clinical decision in VRTs. © Georg Thieme Verlag KG Stuttgart · New York.
Paslakis, G; Schredl, M; Alm, B; Sobanski, E
Adult attention deficit/hyperactivity disorder (ADHD) is characterised by inattention and/or hyperactivity and impulsivity and is a frequent psychiatric disorder with childhood onset. In addition to core symptoms, patients often experience associated symptoms like emotional dysregulation or low self-esteem and suffer from comorbid disorders, particularly depressive episodes, substance abuse, anxiety or sleep disorders. It is recommended to include associated symptoms and comorbid psychiatric disorders in the diagnostic set-up and in the treatment plan. Comorbid psychiatric disorders should be addressed with disorder-specific therapies while associated symptoms also often improve with treatment of the ADHD core symptoms. The most impairing psychiatric disorder should be treated first. This review presents recommendations for differential diagnosis and treatment of adult ADHD with associated symptoms and comorbid psychiatric disorders with respect to internationally published guidelines, clinical trials and expert opinions. © Georg Thieme Verlag KG Stuttgart · New York.
The reply concentrates on advancing again my third thesis, which has not directly been taken up by Breyer and Kliemt. The thesis says that both criticisms against the Rule of Rescue - the irrationality objection, which Breyer and Kliemt try to defend, and the objection that the Rule is discriminatory, which they do not defend - are the results of insufficient action-theoretical reflection. I argue that Breyer's and Kliemt's objection to the Rule, unstable as it is in their comment, is not even clearly identifiable if they do not take a stance towards the central question: Do they want to - and, if so, can they consistently - incorporate people's interest in taking account of the attributability of an outcome to a decision maker into their utility concept? © Georg Thieme Verlag KG Stuttgart · New York.
An obligation to be healthy in the sauce of a categorical imperative "You shall change your life!" (P. Sloterdijk) does not exist. There is however a moral responsibility to shape ones own life in such a way that the resulting potentials for development can be realized within one owns possibilities (I. Kant). The example of predictive medicine illustrates, why the right not to know can be a responsible way of self governance when dealing with the knowledge of modern biomedicine. This allows the setting of limits within prevention, which preserve the quality of life of the exposed as well as enabling the individual the "acceptance of self" (R. Guardini). © Georg Thieme Verlag KG Stuttgart · New York.
Ritschl, P; Machacek, F; Strehn, L; Kloiber, J
The patella replacement in revision surgery is a challenge especially in cases of unsufficient bone stock. Depending on the extent of the bone defect, the following videos demonstrate different approaches: Video 1: bone sparing removal of the patella implant: onlay-type patella implants. Video 2: complete cortical bone rim of the patella, residual thickness between 6 to 10 mm: biconvex patella implant. Video 3 and 4: small defects of the cortical bone rim of the patella, residual thickness 1 to 5 mm (patella shell): gull-wing osteotomy, patella bone grafting techniques. Video 5: partial necrosis/defect of the patella shell with incomplete cortical bone rim: porous tantalum patella prosthesis. On account of the various surgical options for different bone defects of the patella, patellectomy and pure patelloplasty should be avoided to prevent functional shortcomings. Georg Thieme Verlag KG Stuttgart · New York.
Hörz-Sagstetter, Susanne; Minow, Anna-Rahel; Erhardt, Ingrid; Barten-Hohn, Julia; Denscherz, Claudia; Buchheim, Anna; Taubner, Svenja; Mertens, Wolfgang
The "Munich Attachment and Effectiveness Study" is a prospective psychotherapy study examining process and outcome of psychoanalytic psychotherapies. The study design and results are exemplified in a single case. At 6 points in time audio-taped and transcribed therapy sessions are evaluated using process instruments (e. g. Psychotherapy Process Q-Set PQS) and interviews (e. g. Operationalized Psychodynamic Diagnostics OPD, Heidelberg Structural Change Scale HSCS, Adult Attachment Interview AAI). In the single case, findings from the psychotherapeutic process (e. g. "therapist is empathic" according to PQS) complement the achieved changes. 5 HSCS problem foci reached level of "restructuring", on the Reflective Functioning Scale a marked change of RF took place and the attachment classification changed over time. The instruments employed in this study corresponded well in assessing change processes in spite of differing theoretical background. © Georg Thieme Verlag KG Stuttgart · New York.
Allert, N; Barbe, M T; Timmermann, L; Coenen, V A
For more than 15 years deep brain stimulation of the subthalamic nucleus and globus pallidus internus have become therapeutic options in advanced Parkinson's disease. The number of patients with long-term treatment is increasing steadily. This review focuses on issues of the long-term care of these Parkinson's patients, including differences of the available deep brain stimulation systems, recommendations for follow-up examinations, implications for medical diagnostics and therapies and an algorithm for symptom deterioration. Today, there is no profound evidence that deep brain stimulation prevents disease progression. However, symptomatic relief from motor symptoms is maintained during long-term follow-up and interruption of the therapy remains an exception. © Georg Thieme Verlag KG Stuttgart · New York.
Drouard, A.; Vernazza, P.; Loehle, S.; Gattacceca, J.; Zander, T.; Eberhart, M.; Meindl, A.; Oefele, R.; Vaubaillon, J.; Colas, F.
Recently and for the very first time, experiments simulating vaporization of a meteorite sample were performed in a wind tunnel near Stuttgart with the specific aim to record emission spectra of the vaporized material. Using a high enthalpy air plasma flow for modeling an equivalent air friction of an entry speed of about 10 km/s, three meteorite types (H, CM and HED) and two meteoritical analogues (basalt and argillite) were ablated and high resolution spectra were recorded simultaneously. After the identification of all atomic lines, we per- formed a detailed study of our spectra using two approaches: (i) by direct comparison of multiplet in- tensities between the samples and (ii) by computation of a synthetic spectrum to constrain some physical parameters (temperature, elemental abundance). Finally, we compared our results to the elemental composition of our samples and we determined how much compositional information can be retrieved for a given meteor using visible sectroscopy.
Rauchenzauner, Markus; Frühwirth, Martin; Hecht, Martin; Kofler, Markus; Witsch-Baumgartner, Martina; Fauth, Christine
We report a girl with autosomal recessive axonal neuropathy with neuromyotonia (ARAN-NM) who presented with asymmetric gait impairment, foot drop, and action myotonia on fast handgrip. Electrophysiological studies showed symmetrical axonal motor greater than sensory neuropathy, and neuromyotonic discharges on needle electromyography. ARAN-NM was confirmed by molecular genetic testing, which revealed a novel homozygous missense variant c.100G > A [p.(Glu34Lys)] in HINT1. This case shows that the diagnosis of ARAN-NM, as a new entity, has to be considered in the differential diagnosis of polyneuropathy in combination with neuromyotonia/action myotonia in children, even with asymmetric clinical presentation. Georg Thieme Verlag KG Stuttgart · New York.
Rössler, V; Richter, R; Walter, M H
Aim: The aim of the present study was to investigate whether men and women differ in the frequency and phenomenology of delusions. Sample: Medical records of all patients who had been admitted to a psychiatric hospital in Germany between 2008 and 2011 for paranoid schizophrenia were analyzed. The sample consisted of 182 delusional inpatients (90 women, 92 men) with the diagnosis of a paranoid schizophrenia. Results: Men and women did not differ in the frequency of delusional themes. Analysis of delusional content, however, revealed considerable differences between them. Women with delusion of reference felt more often as being under constant surveillance compared to men. Men with delusion of reference showed a tendency to involve unspecified persons in their delusions and more often had the feeling of being talked about. Delusion of grandeur in women was more often built upon significant relationships with others. © Georg Thieme Verlag KG Stuttgart · New York.
Panahova, S; Rempp, H; Sipos, B; Malek, N P; Boozari, B
Perivascular epitheloid cell tumor (PEComa) is a rare tumor, characterized by dual Expression of smooth muscle and melanocytic markers. Due to the development of diagnostic procedures, we now diagnose PEComa more often. We report about a case of PEComa of the liver as an accidental finding. We analyze the clinical and morphological characteristics of this tumor and compare it with the data of the literature. Management of patients with PEComa is not yet standardized; therefore biopsy with immunhistochemical staining is necessary for the diagnosis. In case of liver tumors which cannot be classified by their morphology on imaging modalities, it is important to think about this rare entity. © Georg Thieme Verlag KG Stuttgart · New York.
Evolutionary medicine allows new insights into long standing medical problems. Are we "really stoneagers on the fast lane"? This insight might have enormous consequences and will allow new answers that could never been provided by traditional anthropology. Only now this is made possible using data from molecular medicine and systems biology. Thereby evolutionary medicine takes a leap from a merely theoretical discipline to practical fields - reproductive, nutritional and preventive medicine, as well as microbiology, immunology and psychiatry. Evolutionary medicine is not another "just so story" but a serious candidate for the medical curriculum providing a universal understanding of health and disease based on our biological origin. © Georg Thieme Verlag KG Stuttgart · New York.
Kühne, Franziska; Krattenmacher, Thomas; Bergelt, Corinna; Bierbaum, Anna-Lena; Christine Ernst, Johanna; Flechtner, Hans-Henning; Keller, Monika; Klitzing, Kai V; Romer, Georg; Möller, Birgit
The purpose of this study was the analysis of psychological distress and health-related quality of life (HRQoL) of parents with minor children during curative resp. palliative treatment.Cross-sectional design with a sample of N=89 parent dyads. Dyadic analysis of demographic, illness and family variables via mixed linear models.Patients and healthy partners indicated psychological distress on different subscales. Intradyadic correlations were small-moderate. Most important predictors of psychological distress and HRQoL were treatment stadium, gender, family functioning, and employment status.Dependent on demographic variables, psychooncological support was evident mainly for parents in palliative care and for families with dysfunctional functioning. © Georg Thieme Verlag KG Stuttgart · New York.
Wirth, Rainer; Lueg, Gero; Dziewas, Rainer
The prevalence of oropharyngeal dysphagia in older persons is high. Because it is frequently undetected, screening tests should be applied in risk groups. If the screening test is positive or typical risk factors are present, an instrumental assessment should be utilized. Objective diagnostic tools such as endoscopic evaluation and videofluoroscopy allow the description of the individual dysphagia pattern, which is the basis for an individualized treatment. The endoscopic evaluation of swallowing is increasingly used because it includes several advantages. Potential therapeutic strategies are multifaceted. The evidence for the effectiveness of adaptive, compensatory and rehabilitative strategies is growing, supporting the evolution of dysphagia therapy to an evidence based treatment. © Georg Thieme Verlag KG Stuttgart · New York.
Kortüm, K; Reznicek, L; Leicht, S; Ulbig, M; Wolf, A
The importance and complexity of clinical trials is continuously increasing, especially in innovative specialties like ophthalmology. Therefore an efficient clinical trial site organisational structure is essential. In modern internet times, this can be accomplished by web-based applications. In total, 3 software applications (Vibe on Prem, Sharepoint and open source software) were evaluated in a clinical trial site in ophthalmology. Assessment criteria were set; they were: reliability, easiness of administration, usability, scheduling, task list, knowledge management, operating costs and worldwide availability. Vibe on Prem customised by the local university met the assessment criteria best. Other applications were not as strong. By introducing a web-based application for administrating and organising an ophthalmological trial site, studies can be conducted in a more efficient and reliable manner. Georg Thieme Verlag KG Stuttgart · New York.
Schloot, N C; Roden, M; Bornstein, S R; Brendel, M D
INTERVENTIONAL APPROACHES TO BETA CELL PRESERVATION: In a pilot study, initial attempts at primary prevention by preserving islet beta cells have been successful with highly hydrolyzed milk formula in children who are at high genetic risk of diabetes. Attempts at secondary prevention by intranasal application in children with a high-risk HLA genotype and positive islet autoantibodies have been disappointing. But in tertiary prevention anti-inflammatory, antigen-directed and T-cell targeted treatment has been partially successful in slowing down the destruction of beta cells. BIOLOGICAL BETA CELL SUBSTITUTION: Transplantation of a vascularised pancreas or islet cells results in disease regression and the prevention of secondary/tertiary complications of diabetes. A principal aim is the avoidance of frequent, severe hypoglycaemic episodes resulting from markedly reduced awareness of hypoglycaemia or its counter-regulation. © Georg Thieme Verlag KG Stuttgart · New York.
Dirmaier, Jörg; Tlach, Lisa; Liebherz, Sarah; Kocalevent, Rüya; Sänger, Sylvia; Thiel, Juliane; Härter, Martin
The purpose of this project was to develop a user-centered web-portal for empowerment in mental disorders. The development of the portal included mixed-methods techniques for needs assessment to identify user-relevant content. Exposure and use of the portal was investigated as part of a process evaluation. psychenet.de informs about mental disorders and treatment option. Results of the process evaluation showed a highly accessed website, the portal was assessed as "good" or "very good" by 73 % of the respondents. Using psychenet.de attempts to raise awareness, to inform about mental disorders, and to engage patients in the course of their treatment. © Georg Thieme Verlag KG Stuttgart · New York.
von Bauer, Rüdiger; Oikonomou, Dimitrios; Sulaj, Alba; Kopf, Stefan; Fleming, Thomas; Rudofsky, Gottfried; Nawroth, Peter
Atherosclerosis is an inflammatory disorder in which several converging immune responses modulate and induce lipid accumulation in macrophages. Activated leukocyte cell adhesion molecule (ALCAM) has been described as a structural homologue of HDL-receptor and functions as a pattern recognition receptor (PRR), while its soluble form sALCAM is involved in ALCAM-dependent and -independent immune mechanisms. The aim of this study was to investigate the effect of aggressive removal of low density lipoprotein-cholesterol (LDL-C) and lipoprotein(a) (Lp [a]) by lipoprotein-apheresis (LA) on sALCAM and blood viscosity as well as to evaluate its association with lipoproteins and serum markers of inflammation. © Georg Thieme Verlag KG Stuttgart · New York.
He, Kexin; Zhao, Lili; Bu, Shoushan; Liu, Li; Wang, Xiang; Wang, Min; Fan, Zhining
Esophageal caustic stricture is a stubborn disease and postoperative restenosis limits the clinical efficacy of endoscopic dilation. Autologous mucosal grafts have been successfully applied in the treatment of urethral stricture and in the prevention of stricture after extensive mucosal resection. We aimed to use mucosal autografting performed endoscopically to treat refractory esophageal stricture. METHODS : Three patients with intractable corrosive esophageal stricture were treated endoscopically by combining dilation with autologous mucosal transplantation. RESULTS : All procedures were successful with no severe complications. Mucosal regeneration was shown at the transplanted segments. One patient was able to maintain a normal diet with complete remission after 1 year of follow-up. Intraluminal stenosis and dysphagia were significantly improved in another two patients. CONCLUSIONS : Mucosal autografting can achieve esophageal re-epithelialization, inhibit undesired fibrosis, prevent restenosis, and promote functional regeneration. © Georg Thieme Verlag KG Stuttgart · New York.
Thielker, Jovanna; Bendella, Habib; Gaudin, Robert A; Grosheva, Maria; Volk, Fabian Gerd; Guntinas-Lichius, Orlando
There are numerous reasons for facial palsy, which range from idiopathic palsy (Bell's palsy) to destruction of the facial nerve by a malignant salivary gland tumor. If the chance of spontaneous recovery is low or there is no drug therapy available, surgery is a therapeutical option. Recently, larger studies were published by specialized centers which enable a more individualized therapeutical concept to achieve tone, symmetry and movement of the paralyzed face based on a detailed preoperative assessment. An important therapy target is the improvement of patient´s quality of life. In the present article, we systematically review the important diagnostic steps and, directly derived from this, the indications for surgical options for reanimation of the mimic function. Furthermore, we provide an overview about a variety of postoperative adjuvant measures as well as on new objective assessment tools to evaluate the therapy results. © Georg Thieme Verlag KG Stuttgart · New York.
Koopmann, Mario; Rudack, Claudia; Weiss, Daniel; Stenner, Markus
Squamous cell carcinoma of the nasal vestibule is a rare entity. In consequence disagreement in etiology, staging system and therapy of primary tumor with or without adjuvant treatment of regional lymph nodes are apparent. Pubmed-Recherche of relevant literature concerning: lymphatic drainage, metastases, incidence, risk factors (leather, nickel, nicotine, human papillomavirus, Staging system (UICC, AJCC, Wang's system), therapy of the primary tumor, regional lymph nodes and immunohistochemistry. Fifty-five studies were found and analyzed. Results are inconsistent. The Wang-classification is recommended. Radiation and surgery are the treatment of choice for small lesions. Larger lesions (T3-Wang) should be treated with a combined approach. In cT1-cT2cN0-situation after accurate diagnostic, an elective therapy of regional lymph nodes is not necessary. © Georg Thieme Verlag KG Stuttgart · New York.
Hauswald, B; Yarin, Y M
The prevalence of allergic diseases is increasing worldwide. The highest increase rate is observed in rhinitis allergica. Apart from the anamnesis, the diagnosis relies mainly on skin tests, laboratory analyses and if necessary provocation tests. Symptomatic and causal therapy with abstention and specific immunotherapy are available as therapeutic means. Specific immunotherapy should be aspired as the method of choice. It is comprised of subcutane and sublingular immunity therapy. Usually native allergens and allergoids are used as therapeutics. Recombinant allergens are currently under development. Modern therapy procedures involving these drugs consist of year-round or pre- and co-seasonal treatment which spans at least 3-4 years. In cases of polyvalent allergy, different types of drugs and therapy procedures can be combined. The future of rhinitis allergica treatment lies in further development of specific immunotherapy. © Georg Thieme Verlag KG Stuttgart · New York.
Brackmann, Florian; Kehrer, Christiane; Kustermann, Wibke; Böhringer, Judith; Krägeloh-Mann, Ingeborg; Trollmann, Regina
GM2 gangliosidosis, AB variant, is a very rare form of GM2 gangliosidosis due to a deficiency of GM2 activator protein. We report on two patients with typical clinical features suggestive of GM2 gangliosidosis, but normal results for hexosaminidase A and hexosaminidase B as well as their corresponding genes. Genetic analysis of the gene encoding the activator protein, the GM2A gene, elucidated the cause of the disease, adding a novel mutation to the spectrum of GM2 AB variant. This report points out that in typical clinical constellations with normal enzyme results, genetic diagnostic for activator protein defects should be performed. Georg Thieme Verlag KG Stuttgart · New York.
The Fukushima accident was the consequence of a preceding 2-fold natural catastrophe: the earth quake of 11 March 2011 and the subsequent tsunami. Due to favourable winds and to evacuation measures the radiation exposure to the general population in Japan as a whole and with some exceptions in the region outside the evacuation zone, too, was low. In this article the attempt is made to give an estimate of health consequences to the public. This is based upon WHO's dose estimates, knowledge of the consequences of the Chernobyl accident, of the atmospheric nuclear bomb testing in Kazakhstan and on the risk of childhood leukaemia after low dose radiation exposure. For Germany, there was no radiation threat due to the accident. Nonetheless, the events in Japan made clear that the rules and standards that were developed for the case of a reactor accident need to be revised. © Georg Thieme Verlag KG Stuttgart · New York.
Söhner, Felicitas Petra; Fangerau, Heiner; Becker, Thomas
Background The purpose of this paper is to analyse the perception of the role of psychoanalysis and psychoanalysts in the coming about of the Psychiatrie-Enquete in the Federal Republic of Germany (West Germany). Methods We performed a qualitative content analysis of expert interviews with persons involved in the Enquete (or witnessing the events as mental health professionals active at the time), a selective literature review and an analysis of documents on the Enquete process. Results Expert interviews, relevant literature and documents point to a role of psychoanalysis in the Enquete process. Psychoanalysts were considered to have been effective in the run-up to the Enquete and the work of the commission. Conclusion Psychoanalysis and a small number of psychoanalysts were perceived as being relevant in the overall process of the Psychiatrie-Enquete in West Germany. Georg Thieme Verlag KG Stuttgart · New York.
Söhner, Felicitas; Becker, Thomas; Fangerau, Heiner
Objectives Analysis of the perception of effects of anthropological psychiatry on the Psychiatrie-Enquete and psychiatric reform in the Federal Republic of Germany (West Germany). Methods Qualitative content analysis of expert interviews and systematic literature search. Results Literary sources and expert interviews point to the impact of the anthropologic concept on discourse on and approach to those suffering from mental illness. The attention focused on the visualisation of material-social and subjective living conditions of persons with mental illness. Reform approaches of anthropological psychiatrists were perceived as a basis for the development of social psychiatry. Academic departments of psychiatry in Frankfurt (Zutt, Kulenkampff) and Heidelberg (von Baeyer, Kisker, Häfner) were considered important centres of innovation and reform. Conclusion The thinking of phenomenological-anthropological psychiatry was understood as a facilitator of the Psychiatrie-Enquete and psychiatric reform in West Germany. © Georg Thieme Verlag KG Stuttgart · New York.
Marjanovic, Ivan; Sarac, Momir; Tomic, Aleksandar; Bezmarevic, Mihailo
A mycotic aneurysm of the thoracic aorta is a rare diagnosis with high mortality. We present two cases of endovascular reconstruction of mycotic descending thoracic aorta. Specific or nonspecific bacterial or other infectious agent in serial samples of blood, urine, cerebrospinal fluid, and pleural puncture was not detected in the first case, but we found in sputum sample Mycobacterium tuberculosis in the second patient. We empirically began by administering broad-spectrum intravenous antibiotics in the first case, with preoperative antibiotic prophylaxis and antituberculotic drugs therapy in the second case, and continued with the same medication for 4 months after endovascular repair. Control computed tomographic scans 6 months after reconstruction showed no endoleak in both patients. Repair of mycotic descending thoracic aortic aneurysms by endoluminal stent graft is reasonable alternative to open surgical intervention. A broad-spectrum antibiotic therapy has a high significance in the treatment of patients with mycotic aneurysm. Georg Thieme Verlag KG Stuttgart · New York.
Hillebrecht, Jennifer; Helmes, Almut; Bengel, Jürgen
After the genocide of Shingal in August 2014 in Northern Iraq, the humanitarian admissions program Sonderkontingent Baden-Württemberg "Schutzbedürftiger Frauen und Kinder aus dem Nordirak" was implemented. 1100 persons, most of them Yazidis, were hosted by different municipalities in Germany. The target group is a particularly vulnerable group of persons with a high risk for developing post-traumatic stress disorder. We present the concept of care in Freiburg for 205 Yazidi women and children in Freiburg. A stepped-care approach was developed for the psychological care to introduce the Yazidi people to the daily life and to the health care system in Germany. An outreach of psychological services and an interdisciplinary and multidisciplinary cooperation of all services involved were crucial. © Georg Thieme Verlag KG Stuttgart · New York.
Huckert, Thomas Frank; Hank, Petra; Krampen, Günter
This study empirically tests symptom changes in a sample of 106 psychotherapy outpatients during a 6-month waiting period before treatment commencement. Using indirect measurement of change, the patients improve in psychopathological symptoms. Using direct measurement of change, 48% of the outpatients show no significant change in psychopathological symptoms. However, the symptoms of 29% improve and 23% worsen. Using multinomial logistic regression, group membership (no change, positive change, negative change) can be predicted by personality traits for 60% of the patients. Social trust negatively predicts changes for the worse. Liberal gender-role orientation positively predicts improvement. A positive self-concept of ability positively predicts changes for the worse. Moreover sociodemographic variables correctly predict group membership for 57% of the patients. Age positively predicts changes for the worse. Female gender negatively predicts improvement. © Georg Thieme Verlag KG Stuttgart · New York.
de Leon, Jose
In 2004, 2011, and 2017, the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), a group of German-speaking psychiatric researchers and psychiatrists, published successive versions of therapeutic drug monitoring (TDM) expert group consensus guidelines. The 2017 version has as a major strength its encyclopedic nature, including 1358 references. The guideline has 3 major sections: 1) theoretical aspects of TDM, 2) drug concentration levels in blood to guide neuropsychopharmacotherapy, and 3) practical aspects of TDM in psychiatry and neurology. The writer hopes the time is right for a TDM guideline in psychiatry, which is indicated for: 1) psychiatric researchers ready to value how TDM can contribute to moving psychopharmacology forward, 2) flexible clinicians ready to improve their patient care by personalizing dosing, and 3) today's psychiatry residents prepared as a new generation ready to be trained in TDM and willing to continue incorporating TDM as new psychiatric drugs are marketed. © Georg Thieme Verlag KG Stuttgart · New York.
Müller, Thorben; Doll, Dietrich; Kliebe, Frank; Ruchholtz, Steffen; Kühne, Christian
The term "Damage-control" is borrowed from naval terminology. It means the initial control of a damaged ship. Because of the lethal triad in multiple injured patients the classical concept of definitive surgically therapy in the acute phase of the injury has a high rate of complications such as exsanguination, sepsis, heart failure and multiple organ failure. The core idea of the damage control concept was to minimize the additional trauma by surgical operations in these critical patients in the first phase. This means temporary control of a hemorrhage and measures for stopping abdominal contamination. After 24 - 48 hours in the intensive care unit and correction of physiological disturbances further interventions are performed for definitively treatment of the injuries. Summarized, the damage control strategy comprises an abbreviated operation, intensive care unit resuscitation, and a return to the operating room for the definitive operation after hemodynamic stabilisation of the patient. © Georg Thieme Verlag Stuttgart · New York.
Brüggemann, Silke; Sewöster, Daniela; Kranzmann, Angela
This study describes the quantitative importance of exercise therapy in German medical rehabilitation based on 2014 routine data of the German Pension Insurance. It also shows changes in comparison with data from 2007. Data from 710012 rehabilitation discharge letters comprising 83677802 treatments from central indications in medical rehabilitation were analysed descriptively. Overall 35.4% of treatments could be classified as exercise therapy. Total and relative duration, percentage of individual treatment and kind of exercise treatment varied between indications in 2007 as well as in 2014. There were also differences between sexes, age groups and settings. During the period examined the high importance of exercise therapy in German medical rehabilitation has increased. The results point at a meaningful concept behind the composition of exercise therapy taking indications and disease related factors into account. © Georg Thieme Verlag KG Stuttgart · New York.
Ludolph, Ingo; Lehnhardt, Marcus; Arkudas, Andreas; Kneser, Ulrich; Pierer, Gerhard; Harder, Yves; Horch, Raymund E
During the last two decades, understanding and experience of microsurgical reconstruction have increased. This is linked to improved instruments and technical devices, as well as to the increased number of available donor sites for microvascular flap transfer. If the indication is appropriate, it is now possible to perform personalised, safe and successful microsurgical reconstructions, almost independently of the patients' age. Despite these constant developments, there is little specific literature on microsurgery related to the specific problems of the elderly patient. During two consensus workshops organised by the DAM (German Speaking Working Group for Microsurgery of the Peripheral Nerves and Vessels), the latest findings and experience with microsurgical reconstruction in the elderly patient were presented by a group of experts and current recommendations were formulated. On the basis of these consensus workshops and the current literature, this article discusses important issues in this area. Georg Thieme Verlag KG Stuttgart · New York.
Raigani, Siavash; Numanoglu, Alp; Schwachter, Marc; Ponsky, Todd A
Tele-education has the potential to facilitate rapid sharing and dissemination of current research and knowledge among pediatric surgeons around the world. Classically, the exchange of surgical research occurred via national surgical conferences, articles published in peer-reviewed journals, and textbooks. The advent of Web 2.0 and the rapid pace of technologic advancement have allowed knowledge, education, and research to be exchanged online. Virtual symposiums act as online conferences where participants present and debate new research and surgical techniques in real-time web meetings. Resource libraries allow up-to-date information to be archived and viewed at the user's convenience, bypassing the need to wait long periods for paper publications. Tele-education allows pediatric surgeons to connect and share ideas around the world, while saving time and money. Georg Thieme Verlag KG Stuttgart · New York.
Diener, Hans Christoph; Holle-Lee, Dagny; Nägel, Steffen; Gaul, Charly
A precondition for the successful treatment of headaches is the correct headache diagnosis. Triptans are effective for attack treatment of migraine and cluster headache. However, there are not effective for the treatment of tension-type headache. For the prevention of frequent episodic migraine betablockers, flunarizine, topiramate and amitriptyline are recommended. For the prevention of chronic migraine evidence is only available for onabotulinumtoxinA and topiramate. For prophylactic treatment of tension-type headaches tricyclic antidepressants are used. In cluster headache verapamil (in combination with steroids) is the most frequently used prophylactic agent. This article focusses on the current acute and prophylactic treatment of common headache syndromes. © Georg Thieme Verlag KG Stuttgart · New York.
Hüppe, Tobias; Kneller, Nicole; Raddatz, Alexander
Ambulatory surgery in elderly patients continues to increase - avoiding hospitalization and thus postoperative cognitive dysfunction in older patients being its major objectives. An upper age limit in outpatient anesthesia does not exist to date. However, functional rather than chronological age is crucial in patient selection. In consensus discussion, baseline functional status should be evaluated regularly - defined as everyday behaviors necessary to maintain daily life and encompassing areas of physical, cognitive, and social functioning. Moreover, frailty in elderly patients can be quantified objectively and is associated with increased perioperative morbidity in ambulatory general surgery. The decision for or against outpatient anesthesia therefore remains a case-by-case decision which should be discussed within a team. Georg Thieme Verlag KG Stuttgart · New York.
Heringlake, Matthias; Schmidt, Christian; Brandt, Sebastian
Patients undergoing cardiac surgery are growing older, present with more comorbidities, and are frequently scheduled for more complex and prolonged surgical procedures. Routine application of neurological as well as extended hemodynamic monitoring combined with goal-directed perioperative hemodynamic optimization, targeting optimization of systemic and cerebral oxygen balance, show promise to reduce postoperative complications and to improve mortality in this high risk population. Expert recommendations suggest to avoid synthetic colloids for fluid optimization. Additionally, pathophysiological reasoning and results from recent trials suggest to start inotropic and vasoactive therapy primarily with non-adrenergic drugs like levosimendan and vasopressin and to add classical catecholamines like dobutamine and noradrenalin only if necessary to accomplish hemodynamic goals. Georg Thieme Verlag KG Stuttgart · New York.
Lescan, Mario; Hornung, Andreas; Hofbeck, Michael; Schlensak, Christian
Post-coarctation of the aorta (CoA) pseudoaneurysms is a complication of open repair. Thoracic endovascular repair (TEVAR) is feasible but complicated by proximity to the supra-aortic trunks and severe arch angulation. We describe three cases of post-CoA pseudoaneurysms treated with custom-made Relay stent grafts (Vascutek, Scotland). Technical and clinical success was achieved in all three cases with no mortality, morbidity, endoleaks, or complications. In all three, pseudoaneurysm sac shrinkage was observed at the follow-ups; in one case, there was complete resolution. Redo open surgery is challenging because of adhesions of the thoracic cavity and associated morbidity and mortality. TEVAR is less invasive and offers fewer complications. Custom-made modifications overcome difficult anatomies including short landing zones and diameter variability. Georg Thieme Verlag KG Stuttgart · New York.
Renner, Jochen; Bein, Berthold; Broch, Ole
The anaesthesiological management of patients scheduled for cardiac surgery has been refined distinctively over the last decade due to different reasons. The continuing growth of the elderly patient population and the increasing number of combined cardiac surgery procedures in octogenarians on the one hand are one aspect. The rapid development of minimally invasive cardiac surgery and the enhancements in mechanical, artificial heart assist devices on the other hand can be seen as additional decisive factors. All of these innovations in the field of cardiac surgery implicate further enhancements regarding the anaesthesiological management. This review article addresses the following subareas of cardiac anaesthesia: significance of pharmacological myocardial protection, anaesthetic management during cardiopulmonary bypass, importance of "Enhanced Recovery After Cardiac Surgery"-protocols as well as innovations in the field of minimally invasive cardiac surgery like transcatheter aortic valve implantation. Georg Thieme Verlag KG Stuttgart · New York.
Bein, Berthold; Schiewe, Robert
The transfusion of allogeneic blood products is associated with increased morbidity and mortality. An impaired hemostasis is frequently found in patients undergoing cardiac surgery and may in turn cause bleeding and transfusions. A goal directed coagulation management addressing the often complex coagulation disorders needs sophisticated diagnostics. This may improve both patients' outcome and costs. Recent data suggest that coagulation management based on a rational algorithm is more effective than traditional therapy based on conventional laboratory variables such as PT and INR. Platelet inhibitors, cumarins, direct oral anticoagulants and heparin need different diagnostic and therapeutic approaches. An algorithm specifically developed for use during cardiac surgery is presented. Georg Thieme Verlag KG Stuttgart · New York.
Lee, J H; Kim, B K; Seol, D C; Byun, S J; Park, K H; Sung, I K; Park, H S; Shim, C S
Nonvariceal upper gastrointestinal (UGI) bleeding recurs after appropriate endoscopic therapy in 10 % - 15 % of cases. The mortality rate can be as high as 25 % when bleeding recurs, but there is no consensus about the best modality for endoscopic re-treatment. The aim of this study was to evaluate clipping and detachable snaring (CDS) for rescue endoscopic control of nonvariceal UGI hemorrhage. We report a case series of seven patients from a Korean tertiary center who underwent endoscopic hemostasis using the combined method of detachable snares with hemoclips. The success rate of endoscopic hemostasis with CDS was 86 %: six of the seven patients who had experienced primary endoscopic treatment failure or recurrent bleeding after endoscopic hemostasis were treated successfully. In conclusion, rescue endoscopic bleeding control by means of CDS is an option for controlling nonvariceal UGI bleeding when no other method of endoscopic treatment for recurrent bleeding and primary hemostatic failure is possible. © Georg Thieme Verlag KG Stuttgart · New York.
Hefner, J; Klask, J; Gerding, H
Endonasal dacryocystorhinostomy (DCR) has been established as a standard procedure of lacrimal surgery, since it causes much less tissue damage than ab externo procedures. Diffiulties in visualization of the target area has been a limitation to the transnasal approach. An improvement of the classical endonasal DCR was achieved by the introduction of a transcanalicular endoillumination (TCE) of the lacrimal sac using a 23-Gauge vitreoretinal light probe, which can easily be intubated into the cannaliculi and advanced into the the lacrimal sac. Illumination of the lacrimal sac guides the endonasal approach and facilitates the creation of a lacrimal bypass. In our standard procedure a bicanalicular silicone intubation through the osteotomy is finally placed. Due to the introduction of TCE of the lacrimal sac, the surgical procedure of endonasal DCR became less traumatic and needed a significantly reduced operating time. Georg Thieme Verlag KG Stuttgart · New York.
Linthorst, K; Bauer, U; Osipov, I; Pinheiro, P; Rehder, M
Children of parents who suffer from mental health disorders are more likely to develop mental disorders than children of parents not suffering from mental disorders. For children at risk, preventive strategies are hardly available and, if available, rarely supported by a scientific evaluation. "Kanu - Gemeinsam weiterkommen (canoe - moving jointly forward)" is a preventive strategy that was developed within a research project focusing on primary prevention in children who live in families with parents affected by mental disorders. The intervention is characterised by a multi-modular concept and was tested in the adult psychiatric setting. Preliminary results indicate a preventive impact of the intervention programme. © Georg Thieme Verlag KG Stuttgart · New York.
Wlodarczyk, Olga; Metzner, Franka; Pawils, Silke
Objective The aim of the present study was to assess the health care situation and barriers to support minor children of mentally ill parents from the perspective of adult psychiatry in Germany. Methods Based on the German Hospital Register mental health practitioners of all psychiatric clinics in Germany were asked to answer a 37-item questionnaire. Overall, 441 practitioners of 239 psychiatric clinics participated in the cross sectional study. Results Most important barriers were high workload, scarce resources, patient-focused treatment, missing expertise as well as insufficient awareness. Conclusions More resources, training, clear declaration of competence and coordination of services are necessary to implement family sensitive services in psychiatric clinics. © Georg Thieme Verlag KG Stuttgart · New York.
Nienaber, A; Wieskus-Friedemann, E; Kliem, S; Hoppmann, J; Kemper, U; Löhr, M; Kronmüller, K-T; Wabnitz, P
Objective: Evaluation of a project offering low-threshold anonymous counseling services jointly by mental health services and child and youth services to support children in families with mentally ill parents Methods: Evaluating performance data and completed questionnaires returned by parents included in the project. Results: Between 2011-2014, 150 families received up to 10 sessions of family-oriented counseling. The survey results indicate a high level of satisfaction with the services of the cooperation project. The vast majority of respondents said that they would recommend this service to others or would themselves take advantage of the services again. Conclusion: A collaboration of service providers from psychiatry and child and youth welfare department resulting in continuous availability of counseling with a common family medical perspective represents a forward-looking model for families with a mentally ill parent. © Georg Thieme Verlag KG Stuttgart · New York.
Garlipp, B; Schulz, H-U; Böttcher, S; Lemke, A; Meyer, F; Lippert, H
Obstruction of bile flow following pancreatoduodenectomy can be caused by stenosis of the hepaticojejunostomy created at the time of surgery, obstruction of the bile-draining jejunal loop, stones or, very rarely, ingested foreign bodies in the common hepatic duct. In analogy with endoscopic sphincterotomy or the once popular side-to-side-choledochduodenostomy, the creation of a hepaticojejunostomy eliminates the barrier of the sphincter Oddi, enabling intestinal content such as ingested foreign bodies or food fibers to migrate into the bile duct. We report on the case of a patient developing biliary tract obstruction due to fibrous material in the common hepatic duct 15 years after pancreatoduodenectomy. In addition, an overview of the literature on the rare phenomenon of foreign body-associated obstructive jaundice is given. © Georg Thieme Verlag KG Stuttgart · New York.
Tagay, Sefik; Düllmann, Sonja; Schlegl, Sandra; Nater-Mewes, Ricarda; Repic, Nevena; Hampke, Christian; Brähler, Elmar; Gerlach, Gabriele; Senf, Wolfgang
The aim of the present prospective-naturalistic study was the evaluation of psychosomatic inpatient treatment for anorexia nervosa (AN) and bulimia nervosa (BN). 128 patients with eating disorders (n=59 AN and n=69 BN) were investigated on admission and discharge using the following standardized questionnaires: eating disorder symptoms (EDI), general psychopathology (BSI), quality of life (SF-12), and personal resources (SOC-13, SWE). Moderate to large effect sizes were achieved for the eating disorder symptoms; in addition, general psychopathology was substantially reduced at the end of treatment, and quality of life as well as personal resources were enhanced. Personal resources were found to be the strongest predictors for therapy outcome. Based on our data, important insights and recommendations may be gained for the inpatient treatment of eating disorders, especially with regard to the potential influence of personal resources. © Georg Thieme Verlag KG Stuttgart · New York.
Work-anxieties are often going along with workplace problems and long-term sick leave. Psychopathologically, different qualities of work anxiety can be distinguished: worrying, phobic anxiety, health-related anxiety, anxiety of insufficiency. An evaluation of a work-anxiety treatment showed that confronting patients with the topic work during medical rehabilitation leads to a better course. In work-oriented capacity trainings or behavior therapy groups, coping with everyday phenomena at work may be trained (self-presentation, social rules, work organization and problem solving, coping with chronic illness and impairment conditions). Active coping and communication (explaining impairment to the supervisor and occupational physician for making problem solving possible) are helpful. In some cases, correction of expectations must be done, and normalizing everyday work problems (conflicts and achievement requirements are normal at work, work does not make happy all the time). © Georg Thieme Verlag KG Stuttgart · New York.
Zehnder, Ursina; Rabenschlag, Franziska; Panfil, Eva-Maria
Special observation is a seriously invasive and resource intensive intervention. It is necessary to scientifically conceptualise this measure for further investigations and practice. Evolutionary concept analysis. The identified antecedents, attributes and consequences of special observation range between control and therapy as well as the safety of patients and the coverage of the professionals. Antecedents comprise of legitimisation (indication, assessment, prescription), resources (internal guidelines, architectural structures, information) as well as context factors (security needs, personal attitudes). The identified attitudes are organisation (qualification, shifting carers, length, place), intervention (relationship, re-assessment, transparency) as well as the field of tension between control and therapy. The consequences consist of side effects (patients, nurses, resources) and conflicts (ethical dilemmas, role conflicts). Society and discipline have influenced the concept over time and a distinction between the custodial and controlling pattern versus a therapeutic approach is recommended. © Georg Thieme Verlag KG Stuttgart · New York.
Corrieri, Sandro; Conrad, Ines; Riedel-Heller, Steffi G
To assess how Info-Pocket-Guides (IPG) are judged as an overall concept, with specific consideration for their content and design in terms of a successful contribution to the prevention of mental illnesses. Altogether, eight student focus groups were conducted and differentiated according to sex, age, and educational system. Mainly, the respondents consider the IPGs as an appealing design, as well as a convenient and well-liked source of information. Some amendments regarding the range of topics were suggested. While there were doubts on the direct benefit of IPGs for the affected person, they were considered highly valuable for relatives and friends. For the acceptance of IPGs, an age-appropriate and context-involving mediation was found decisive. © Georg Thieme Verlag KG Stuttgart · New York.
Gutwinski, Stefan; Schreiter, Stefanie; Priller, Josef; Henssler, Jonathan; Wiers, Corinde E; Heinz, Andreas
Regular alcohol consumption affects cognitive performance and the development of dementia. So far, findings are contradicting, which might be explained in part by dose-related effects. For this narrative review, we undertook a literature search for surveys investigating the impact of alcohol consumption on cognitive performance and the development of dementia. The majority of studies observed a U-shaped relationship between regular alcohol consumption and cognitive function: frequent heavy consumption of alcohol alters brain functions and decreases cognitive performance; regular light and moderate consumption may have protective impact. In many studies, total abstainers show an inferior cognitive performance than people with moderate or light consumption. Nevertheless, policy implications are difficult to draw for at least 2 reasons: (1) the possible risks associated with alcohol consumption and (2) the potential confounders in the group of non-consumers and heavy consumers. © Georg Thieme Verlag KG Stuttgart · New York.
Schilling, Tobias; Rauscher, Stephan; Menzel, Christian; Reichenauer, Simon; Müller-Schilling, Martina; Schmid, Stephan; Selgrad, Michael
Due to the current geopolitical situation more refugees from crisis countries were and will be treated in Europe. In 2015 the number of displaced people reached an unprecedented level, with more than one million crossing into Europe. The migration itself can impair both mental and physical health. Therefore, the provision of medical care for refugees and migrants is a novel and major challenge for the health care systems in Europe. In this article we describe our experiences and contribution in providing medical care for refugees who have newly arrived in Stuttgart, Baden-Wuerttemberg, Germany. Furthermore, we report our experiences from a tertiary referral University center in Regensburg, Bavaria, Germany. We focus on challenges in both the outpatient and the inpatient setting, with a special focus on intensive care patients. In addition, we provide an overview about the spectrum of diseases in this specific patient cohort.
Balke, M; Wunderlich, G; Brunn, A; Fink, G R; Lehmann, H C
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic progressive or relapsing autoimmune neuropathy with heterogeneous clinical presentation. Symptoms typically include symmetrical, proximal and/or distal paresis and sensory loss. Atypical CIDP variants are increasingly recognized, including subtypes with rapid onset as well as variants with pure sensory, focal or marked asymmetrical deficits. Diagnosis is established by compatible symptoms, characteristic electrophysiological features and cerebrospinal fluid analysis. In unequivocal cases, inflammatory infiltrates in sural nerve biopsy support the diagnosis. Recent studies suggest that diagnostic imaging techniques such as MRI and nerve ultrasound may become useful tools for establishing the diagnosis. First-line therapies include immunoglobulines, steroids, and plasmapheresis. Immunosuppressant agents and monoclonal antibodies are used in therapy-refractory cases or as cortison-saving agents. © Georg Thieme Verlag KG Stuttgart · New York.
Krudewig, J; Baumann, U; Bernuth von, H; Borte, M; Burkhard-Meier, U; Dueckers, G; Foerster-Waldl, E; Franke, K; Habermehl, P; Hönig, M; Kern, W; Kösters, K; Kugel, K; Lehrnbecher, T; Liese, J; Marks, R; Müller, G A; Müller, R; Nadal, D; Peter, H-H; Pfeiffer-Kascha, D; Schneider, M; Sitter, H; Späth, P; Wahn, V; Welte, T; Niehues, T
Currently, management of antibody deficient patients differs significantly among caregivers. Evidence and consensus based (S3) guidelines for the treatment of primary antibody deficiencies were developed to improve the management of these patients. Based on a thorough analysis of current evidence (systematic literature search in PubMed; deadline November 2011) 14 recommendations were finalized during a consensus meeting in Frankfurt in November 2011 using structured consensus methods (nominal group technique). Experts were nominated by their scientific societies/patient initiatives (Tab. 1). The guidelines focus on indication, practical issues and monitoring of immunoglobulin replacement therapy as well as on different routes of administration. Furthermore recommendations regarding supportive measures such as antiinfective therapy, vaccinations and physiotherapy are given. Combining literature evidence and experience of caregivers within this evidence and consensus based guidelines offers the chance to improve the quality of care for anti-body deficient patients. © Georg Thieme Verlag KG Stuttgart · New York.
Joussen, A M; Kirchhof, B
This review assesses the relevance of surgical approaches for age-related macular degeneration (AMD) with respect to the pathophysiology of AMD and the current pharmacological possibilities. We discuss the different surgical approaches such as subretinal membrane excision, cell transplantation (IPE and RPE) and transplantation of retina and choroid (PATCH), as well as translocation surgery. Peeling of epiretinal membranes in patients with drusen as well as vitrectomy before epiretinal brachytherapy (VIDEON system) are the final topics. While overall pharmacotherapy has displaced surgical approaches, surgery is worthy of consideration in selected cases. For these patients surgical options need to be maintained in the armamentarium of retinal surgeons. Georg Thieme Verlag KG Stuttgart · New York.
Gehling, Markus; Tryba, Michael
Hemofiltration with Cytosorb can reduce cytokines in sepsis. Since cytokines are involved in the development of vasodilatatory shock in sepsis, their reduction might improve the chance of survival in this condition. In spite of the CE-approval of Cytosorb clinical efficacy has not been proved so far. Other techniques reducing cytokines by direct or indirect manners failed to prove an influence on sepsis mortality. Moreover, the nonspecific elimination of pro- and anti-inflammatory cytokines may result in different clinical effects. Benefits and risks of nonspecific cytokine elimination may be determined by the interaction of pro- and anti-inflammatory cytokines. Therefore, the usefulness of cytokine elimination using Cytosorb cannot be estimated without clinical data. The application of cytosorb in life threatening septic shock should be accompanied by a critical discussion of the limits of these curing trials. © Georg Thieme Verlag KG Stuttgart · New York.
Latawitz, Toni; Spielau, Ulrike; Lipek, Tobias; Gausche, Ruth; Lück, Martina; Kiess, Wieland; Grande, Gesine; Igel, Ulrike
Eating habits are influenced by individual socioeconomic status (SES). As the association between neighbourhood characteristics and food availability is still unclear, we investigated the community nutrition environment in different neighbourhoods. Using official data of the city of Leipzig, we selected three neighbourhoods which differed in terms of their social (2 deprived vs. 1 affluent) and built (1 large housing estates vs. 2 historic buildings) environment. Data on food outlets were assessed via direct observation (ground truthing). Social and residential environment characteristics are associated with food availability. The proportion of fast food outlets is higher in deprived neighbourhoods compared to the affluent one (25%, 30.4% vs. 13.5%). Neighbourhoods with historic buildings offer a greater variety of food outlets. The greater availability of unhealthy food may contribute to the development of obesity. Preventive measures should consider the physical and social environment. © Georg Thieme Verlag KG Stuttgart · New York.
Kloocke, Ruth; Schmiedebach, Heinz-Peter; Priebe, Stefan
The paper reports an historical analysis of the debate on trauma and psychosis in German psychiatry. Content analysis of five leading German psychiatric journals between 1889 and 2005. A substantial number of publications until the late 1960s addressed different aspects of potential links between trauma and subsequent psychosis. Papers exclusively focused on traumatic experience in adulthood. Most papers showed a negative attitude towards the idea of traumatic experiences causing psychosis. The debate on psychological trauma and psychosis refers to a long tradition in German psychiatry. Whilst the discussion contributed significantly to concepts and classifications of psychotic illnesses, it did not generate a coherent model for the potential association of trauma and subsequent psychotic disorder. Copyright Georg Thieme Verlag KG Stuttgart . New York.
Lei, Jeremy; Burgess, Elaine J; Richardson, Alistair T B; Hawkins, Bill C; Baird, Sarah K; Smallfield, Bruce M; van Klink, John W; Perry, Nigel B
Cytotoxic amides have been isolated from the fruits of the endemic New Zealand medicinal plant kawakawa, Macropiper excelsum (Piperaceae). The main amide was piperchabamide A and this is the first report of this rare compound outside the genus Piper. Eleven other amides were purified including two new compounds with the unusual 3,4-dihydro-1(2H)-pyridinyl group. The new compounds were fully characterized by 2D NMR spectroscopy, which showed a slow exchange between two rotamers about the amide bond, and they were chemically synthesized. In view of the antitumor activity of the related piperlongumine, all of these amides plus four synthetic analogs were tested for cytotoxicity. The most active was the piperine homolog piperdardine, with an IC50 of 14 µM against HT 29 colon cancer cells. Georg Thieme Verlag KG Stuttgart · New York.
Grünberger, Tanja; Laireiter, Anton-Rupert
In an online-survey 152 psychotherapists were asked about their subjectively perceived effects of therapeutic practice on personality and experience in private context. Changes were retrospectively measured by changes in subscales of NEO-FFI and BIP and a newly developed scale. The changes were tested for significance and influences by demographic factors. Compared to the beginning of their professional careers therapists perceived significant increases in agree-ableness, openness, self-confidence and sensitivity, and significant decreases in neuroticism and social isolation. Changes in extraversion were not significant. Demographic factors did not show any significant influence on the perceived changes. Therapeutic practice therefore seems to have a positive influence on the perceived development of personality in psychotherapists by their professional practice. © Georg Thieme Verlag KG Stuttgart · New York.
Kozian, Alf; Schilling, Thomas; Hachenberg, Thomas
In daily practice, acute and chronic pulmonary diseases are common issues presenting to the anesthetist. Respiratory physiology in general is affected by both general and regional anesthesia, which results in an increased number of perioperative complications in pulmonary risk patients. Therefore, anesthetic management of patients with bronchial asthma needs to address different clinical topics: the physical appearance of pulmonary disease, type and extent of surgical intervention as well as effects of therapeutic drugs, anesthetics and mechanical ventilation on respiratory function. The present work describes important precautions in preoperative scheduling of the asthmatic patient. In the operative course, airway manipulation and a number of anesthetics are able to trigger intraoperative bronchial spasm with possibly fatal outcome. It is essential to avoid these substances to prevent asthma attack. If asthmatic status occurs, appropriate procedures according to therapeutic standards have to be applied to the patient. Postoperatively, sufficient pain therapy avoids pulmonary complications and improves outcome. © Georg Thieme Verlag Stuttgart · New York.
Kretz, F T A; Linz, K; Mueller, M; Gerl, M; Koss, M J; Gerl, R H; Auffarth, G U
Nowadays, further developments in the field of intraocular lenses offer a higher level of spectacle independence for our patients. As light gets scattered on different focal points a wider range of defocus is created. This greater defocus area makes it more difficult for us to determine the objective or subjective refraction. This contribution is concerned with the difficulties of measuring visual acuity in different intraocular lens designs and different measurement distances. Measuring refraction after implantation of a multifocal intraocular lens is a complex procedure and the experience of the examiner plays a crucial role. Retinoscopy, keratometry and the defocus curve are reliable methods for testing, while the auto refractometer, bichromatic testing and the cross-cylinder have limitations. Georg Thieme Verlag KG Stuttgart · New York.
Efficient quality management aiming to achieve high quality in patient care is crucial to the success of a surgery department. This requires the knowledge of relevant terms und contexts of quality management. Implementation remains difficult in the light of demographic change and skills shortage. If a hospital has an efficient internal quality management in place, this should be used as a supplementary instrument. Otherwise it is the (sole) task of a specialist department to ensure quality for patients, employees, and cooperative partners. This paper provides basic knowledge on quality management, risk management, and quality assurance in the context of relevant medical terms. It demonstrates new ways for implementation on the level of a surgery department, and introduces a new model of quality. Georg Thieme Verlag KG Stuttgart · New York.
Liu, Yayue; Xia, Guoping; Li, Hanxiang; Ma, Lin; Ding, Bo; Lu, Yongjun; He, Lei; Xia, Xuekui; She, Zhigang
Three new vermistatin derivatives, 6-demethylpenisimplicissin (1), 5'-hydroxypenisimplicissin (2), and 2''-epihydroxydihydrovermistatin (3), along with five known vermistatin analogues, methoxyvermistatin (4), vermistatin (5), 6-demethylvermistatin (6), hydroxyvermistatin (7), and penisimplicissin (8), were isolated from the culture of the mangrove endophytic fungus Penicillium sp. HN29-3B1 from Cerbera manghas. Their structures were elucidated mainly by nuclear magnetic resonance spectroscopy. The absolute configurations of compounds 1 and 2 were deduced on the basis of circular dichroism data. The absolute structures of compounds 3 and 5 were confirmed by a single-crystal X-ray diffraction experiment using Cu Kα radiation. In the bioactivity assay, compounds 1 and 3 exhibited α-glucosidase inhibitory activity with IC50 values of 9.5 ± 1.2 and 8.0 ± 1.5 µM, respectively. The plausible biosynthetic pathways for all compounds are discussed. Georg Thieme Verlag KG Stuttgart · New York.
Pneumonia is one of the oldest and best known diseases in mankind. Morbidity and mortality of this disease are remarkable. This has not been changed with the development of modern antibiotic therapy. On the contrary new challenges have arisen, more elderly and comorbid patients are involved and an increase in antibiotic resistance has appeared. An improvement in diagnosis and the introduction of risk stratification approaches has led to a standardisation in therapy. Vaccination strategies for special pathogens like S. PNEUMONIAE have reduced the burden of disease. For decades research was focused on the development of new antibiotics. The failure of this strategy has directed more attention to the host-pathogen interaction. Modulation of innate immunity is one of the key issues to overcome the future challenges in this field. Copyright Georg Thieme Verlag KG Stuttgart . New York.
Koehler, U; Hildebrandt, O; Jerrentrup, L; Koehler, K-I; Kianinejad, P; Sohrabi, K; Schäfer, H; Kenn, K
Long-term oxygen treatment (LTOT) has been demonstrated to improve prognosis in patients with chronic respiratory insufficiency. In terms of pathogenesis, improved oxygenation, reduction of pulmonary artery pressure as well as reduction of respiratory work are important. Since there are considerable differences between the LTOT systems, individually tailored therapy is needed. In particular, the mobility aspects of the patients must be taken into consideration. It is important to distinguish between stationary/mobile devices with a liquid oxygen system and stationary/mobile devices with oxygen concentrator. Oxygen titration should be performed in relation to rest and activity phases (e. g. 6 minute walk test) as well as in relation to the sleep phase. Employing devices with demand-controlled valves should be critically examined. This can be undertaken only under physician orders and requires continuous monitoring. © Georg Thieme Verlag KG Stuttgart · New York.
Meier, B D; Homann, D
The article summarises the results of a study on the activities of the German public health insurance companies to fight fraudulent behaviour in the system. The study is based on the analysis of 140 activity reports of the years 2004 and 2005 which the companies had to deliver to the Federal Social Insurance Authority as well as on the results of an additional survey. The article deals with the number of cases, the phenomenology of the delinquent acts, the referral of the suspicious cases to the law enforcement agencies, and the cooperation with other insurance companies. Finally, the article presents some considerations on an improved prevention of fraud in the public health care system. Copyright Georg Thieme Verlag KG Stuttgart . New York.
Friemelt, G; Ritter, J
German Pension Insurance as a provider of services in rehabilitation has reacted to demographic changes in society, both strategic and practical. The implementation of services for companies including support of company return to work management and prevention services for employees with specific health-related burdens offer the chance to identify an endangerment of earning capacity at an early stage. Workplace-orientated medical rehabilitation increases the focus on the job and the workplace in rehabilitation under the pension insurance scheme, both in selecting the right service for a client as well as in the service itself. Employers, employees and pension insurance together benefit from close cooperation. © Georg Thieme Verlag KG Stuttgart · New York.
Ueberschaer, Hendrik; Allescher, Hans-Dieter
Proton Pump Inhibitors are among the most common drugs taken. The indication is for treatment of heartburn, reflux disease, prophylaxis and treatment of peptic ulcers, in combination with NSAIDs and steroids as well as H. pylori-eradication. PPI's are widely used, even with non-specific symptoms. This certainly has to do with good tolerability and a previously considered low side effect profile. At the moment, there is growing evidence that the long-term intake of PPI's may not be as safe as assumed. In addition to interactions with some drugs, including platelet aggregation inhibitors, recent studies have shown an increased risk of myocardial infarction, interstitial nephritis, chronic renal injury, infections, vitamin deficiencies and electrolyte shifts as well developing dementia. © Georg Thieme Verlag KG Stuttgart · New York.
Hacker, Ulrich; Lordick, Florian
Endoscopic resection is established in the treatment of early gastric cancer. More advanced gastric cancer requires gastrectomy and D2 lymphadenectomy. Perioperative chemotherapy improves overall survival in locally advanced gastric cancer representing a standard of care. Locally advanced adenocarcinomas of the esophago-gastric junction can alternatively be treated with concurrent radiochemotherapy. In metastatic disease, systemic chemotherapy improves survival, quality of life and symptom control. Trastuzumab plus chemotherapy should be used together with first-line chemotherapy in HER2 positive gastric cancer patients. Second- and third-line therapy is now well established. The anti-VEGFR2 antibody Ramucirumab improves survival in second line treatment both as a monotherapy and in combination with paclitaxel and represents a novel treatment option. © Georg Thieme Verlag KG Stuttgart · New York.
Fundus autofluorescence (FAF) imaging allows for non-invasive mapping of changes at the level of the retinal pigment epithelium/photoreceptor complex and of alterations of macular pigment distribution. This imaging method is based on the visualisation of intrinsic fluorophores and may be easily and rapidly used in routine patient care. Main applications include degenerative disorders of the outer retina such as age-related macular degeneration, hereditary and acquired retinal diseases. FAF imaging is particularly helpful for differential diagnosis, detection and extent of involved retinal areas, structural-functional correlations and monitoring of changes over time. Recent developments include - in addition to the original application of short wavelength light for excitation ("blue" FAF imaging) - the use of other wavelength ranges ("green" or "near-infrared" FAF imaging), widefield imaging for visualisation of peripheral retinal areas and quantitative FAF imaging. Georg Thieme Verlag KG Stuttgart · New York.
Müller, M; Wassilew, G; Perka, C
Particle disease is caused by periarticular accumulation of attrition particles and the inflammatory reaction of the body's tissue. This process may result in osteolysis or soft tissue transformation which presents itself symptomless in the beginning and can proceed to aseptic implant loosening, fracture, implant breaking as a result of the inappropriate osseous support and to algetic and destructive soft tissue reactions as well. Attrition particles originate from tribological pairing, and the extent of the attrition or the particle concentration depend on different factors as there are the tribological pairing's material, the head size, the patient's level of activity, and the implant position. Attrition particles can also be found in the range of any modular connection. Particle disease and its resulting morphological alterations of the tribological pairing is one of the most frequent reasons for re-operation in hip endoprosthetics. Georg Thieme Verlag KG Stuttgart · New York.
Bock, J-O; Brettschneider, C; Seidl, H; Bowles, D; Holle, R; Greiner, W; König, H H
Due to demographic aging, economic evaluation of health care technologies for the elderly becomes more important. A standardised questionnaire to measure the health-related resource utilisation has been designed. The monetary valuation of the resource use documented by the questionnaire is a central step towards the determination of the corresponding costs. The aim of this paper is to provide unit costs for the resources in the questionnaire from a societal perspective. The unit costs are calculated pragmatically based on regularly published sources. Thus, an easy update is possible. This paper presents the calculated unit costs for outpatient medical care, inpatient care, informal and formal nursing care and pharmaceuticals from a societal perspective. The calculated unit costs can serve as a reference case in health economic evaluations and hence help to increase their comparability. © Georg Thieme Verlag KG Stuttgart · New York.
Buschmann, Claas T; Kleber, Christian; Tsokos, Michael; Püschel, Klaus; Hess, Thorsten; Kerner, Thoralf; Stuhr, Markus
Emergency medical research is subject to special conditions. Emergency patients e.g. are generally considered to be non-capable of giving consent. This results in sparse emergency medical data when compared to clinical observation studies under controlled conditions. After emergency medical treatment, deceased patients are not rarely subject to forensic investigation. The cooperation between emergency and forensic medicine has not only emergency medical training potential in individual cases, but also scientific innovation potential especially with respect to the retrospective evaluation of pre-hospital emergency measures. Such partnerships (like in Berlin at the Charité - Universitätsmedizin Berlin between the Institute of Legal Medicine and the Center for Musculoskeletal Surgery or in Hamburg between the Institute for Legal Medicine at the University Hospital and the Municipal Fire Brigade with the Emergency Medical Service) are yet exceptional in Germany. © Georg Thieme Verlag Stuttgart · New York.
Kouzaki, Karina; Nakazato, Koichi; Mizuno, Masuhiko; Yonechi, Tooru; Higo, Yusuke; Kubo, Yoshiaki; Kono, Tokuyoshi; Hiranuma, Kenji
The aim of this study was to assess sciatic nerve conductivity in athletes with a history of hamstring strain injuries. Twenty-seven athletes with a history of hamstring strain injuries were included in the injured group. The control group consisted of 16 uninjured participants. We measured the proximal and distal latencies and calculated the sciatic nerve conduction velocity to evaluate neuronal conductivity. The results were expressed as median values and interquartile ranges. Both proximal latency and distal latency of the injured limb in the injured group were significantly longer than those of the uninjured limb (p<0.05). The nerve conduction velocity of the injured limb in the injured group was significantly lower than that of the uninjured limb (p<0.05). There were no significant side-to-side differences in the control group. Sciatic nerve conductivity impairments may exist in athletes with a history of hamstring strain injuries. © Georg Thieme Verlag KG Stuttgart · New York.
Providing adequate culture-sensitive care for a large number of refugees with trauma-related disorders constitutes a major challenge. In this context, peer support and trauma-informed peer counselling can be regarded as a valuable means to complement the psychosocial care systems. In recent years, peer support and peer education have been successfully implemented e. g. in health care education, in psychiatric care, and in the treatment of traumatized individuals. Only little research data is available for traumatized refugees. However, results are encouraging. A program is presented which integrates trauma-informed peer educators (TIP) with migration background in the care of traumatized refugees. Peers' responsibility includes emotional support and understanding the refugees' needs, sensitizing for trauma-related disorders, providing psychoeducation, and teaching trauma-specific stabilization techniques under supervision of professional psychotherapists. © Georg Thieme Verlag KG Stuttgart · New York.
Guth, C; Beuers, U; Beckh, K
Intermittent cholestatic liver disease may indicate an inherited deficiency of bile salt transport proteins. Episodes of cholestasis may start during pregnancy or during use of oral contraceptives or other medication. We describe the case of a 22-year-old mother with increasing jaundice and severe pruritus two weeks after starting hormonal contraception. A few months before she was suffering from intrahepatic cholestasis of pregnancy (ICP). Liver biopsy showed bland cholestasis with canalicular bile plugs. Treatment with ursodeoxycholic acid was not effective. Finally, rifampicin induced a complete remission of the cholestasis. Genetic testing showed a heterozygous mutation in the ABCB11 gene encoding the bile salt export pump (BSEP). Rifampicin activates nuclear receptors and may induce alternative pathways for the excretion of bile salts in patients with ABCB11 deficiency. © Georg Thieme Verlag KG Stuttgart · New York.
Stackebrandt, E; Scheuerlein, C; Schleifer, K H
The degree of relatedness of nine strains of Stomatococcus mucilaginosus (formerly classified as 'Micrococcus mucilaginosus') was investigated by deoxyribonucleic acid hybridization. We confirm that all strains are highly related. Differences in the peptidoglycan type and the cytochrome pattern between S. mucilaginosus and members of Micrococcus, together with the results of 23 S ribosomal ribonucleic acid cistron similarity studies and the analysis of the 16S ribosomal ribonucleic acid support the exclusion of this species from the genus Micrococcus and justifies its reclassification as a member of a new genus, Stomatococcus (Bergan and Kocur, 1982). Phylogenetically, S. mucilaginosus represents an independent line of descent within a broad group of Gram-positive bacteria that contains arthrobacteria, micrococci, cellulomonads, brevibacteria and microbacteria. Copyright © 1983 Gustav Fischer Verlag, Stuttgart/New York. Published by Elsevier GmbH.. All rights reserved.
Kulzer, M J; Mooyaart, E A Q; Hetterich, H
A 28-year-old man without a significant past medical history presented to our emergency department with severe chest pain and dyspnoa. Vital signs and the rest of the physical examination were unremarkable. The electrocardiogram showed T-wave inversions and the cardiac enzymes were elevated. Angiocardiography showed an aneurysm of the right coronary artery and a thrombus formation in its distal part. Intracoronary thrombolytic therapy was attempted an oral anticoagulation was started. Further investigations did not find the cause of the aneurysmatic RCA. The patient had no further episode of chest pain. Acute coronary syndrome is a rare finding in patients under the age of 30 years. Coronary aneurysms with associated thrombus can be the cause of it. © Georg Thieme Verlag KG Stuttgart · New York.
Waldbauer, Katharina; McKinnon, Ruxandra; Kopp, Brigitte
Apple pomace is a waste product of the apple manufacturing industry that has been in the focus of life sciences as it represents a low-cost source of fruit-derived compounds. High fruit consumption is associated with beneficial health effects, and therefore, apple pomace and its constituents raise therapeutic interest. The present work reviews (i) the chemical constituents of apple pomace, (ii) optimized extraction methods of apple pomace compounds, and (iii) biological activities of apple pomace. Current evidence of apple pomace influence on digestion and metabolism, cholesterol and triglyceride homeostasis, diabetes, and sex hormones is summarized. Furthermore, studies regarding its antioxidative, anti-inflammatory, antiproliferative, antibacterial and antiviral effects are presented. The review concludes that apple pomace is an underutilized waste product of the apple industry with the potential of being processed for its nutritional and pharmaceutical value. Georg Thieme Verlag KG Stuttgart · New York.
Ramis, Ivy B; Vianna, Júlia S; Reis, Ana Júlia; von Groll, Andrea; Ramos, Daniela F; Viveiros, Miguel; da Silva, Pedro E Almeida
New drugs are needed to treat infections with antimicrobial-resistant Mycobacterium abscessus ; therefore, we evaluated usnic acid as an antimicrobial agent and efflux inhibitor (EI) against M. abscessus . Usnic acid showed antimicrobial activity, and synergistically, the EI verapamil increased this activity. In addition, when we evaluated the interaction of antimicrobials with usnic acid, the increase of their activity was observed. Finally, usnic acid showed an efflux inhibitory effect between the classical EIs verapamil and carbonyl cyanide m-chlorophenylhydrazine. In conclusion, usnic acid showed both antimicrobial and EI activity, indicating that this natural compound may be a promising scaffold for new drugs against this difficult-to-treat microorganism. Georg Thieme Verlag KG Stuttgart · New York.
Körner, M; Luzay, L; Becker, S; Rundel, M; Müller, C; Zimmermann, L
Interprofessional collaboration is a main precondition of successful treatment in rehabilitation. In order to improve interprofessional collaboration, a clinic-specific, goal- and solution-oriented and systemic team development approach was designed. The aim of the study is the evaluation of this approach. A multi-centre cluster-randomized controlled study with staff questionnaires. The team development could be implemented successfully in 4 of 5 clinics and led to significant improvements in team organisation, willingness to accept responsibility and knowledge integration. The effects are small and are caused by the opposed development of intervention and control group. The team development approach can be recommended for rehabilitation practice. A train-the-trainer approach will be developed and further studies are planned in order to disseminate the approach and to investigate the conditions of implementation. © Georg Thieme Verlag KG Stuttgart · New York.
Weber, R; Knaup, P; Knietitg, R; Haux, R; Merzweiler, A; Mludek, V; Schilling, F H; Wiedemann, T
The German Society for Paediatric Oncology and Haematology (GPOH) runs nation-wide multicentre clinical trials to improve the treatment of children suffering from malignant diseases. We want to provide methods and tools to support the centres of these trials in developing trial specific modules for the computer-based DOcumentation System for Paediatric Oncology (DOSPO). For this we carried out an object-oriented business process analysis for the Cooperative Soft Tissue Sarcoma Trial at the Olgahospital Stuttgart for Child and Adolescent Medicine. The result is a comprehensive business process model consisting of UML-diagrams and use case specifications. We recommend the object-oriented business process analysis as a method for the definition of requirements in information processing projects in the field of clinical trials in general. For this our model can serve as basis because it slightly can be adjusted to each type of clinical trial.
Resource allocation decisions in health care require the consideration of ethical values. Major ethical theories include Amartya Sen's capability approach, Norman Daniels's theory of justice for health, and preference utilitarian theory. This paper argues that while only preference utilitarian theory explicitly considers the impact of an individual's actions on others, all 3 theories agree in terms of providing individual autonomy. Furthermore, it shows that all 3 theories emphasise the role of informed preferences in securing individual autonomy. Still, stressing personal autonomy has limited direct implications for priority setting. 2 priority rules for resource allocation could be identified: 1) to give priority to patients with mental disability (over those with pure physical disability); and 2) to give priority to patients with a large expected loss of autonomy without treatment. © Georg Thieme Verlag KG Stuttgart · New York.
Scheid, Christof; Munder, Markus; Salwender, Hans; Engelhardt, Monika
Combination therapies such as Dara-Rd and Dara-Vd show significantly higher survival rates after 12 months than the respective therapies without Daratumumab. The initial infusion of Daratumumab is associated with a high incidence of IRR. Dosage and speed of infusion of Daratumumab have to be strictly controlled. Any suspicion of even low IRR requires corrections. Concomitant medication before and after Daratumumab administration is required. For this purpose, various preparations have been tested in everyday clinical practice. Eight hours of infusion may be required. This does not only overwhelm the patient, but also the most ambulant structures. The split-dose concept means to divide the dose into infusions on different days. Again, the dosage is crucial for good compatibility. © Georg Thieme Verlag KG Stuttgart · New York.
Schachtsiek, Julia; Warzecha, Heribert; Kayser, Oliver; Stehle, Felix
The plant Cannabis sativa contains a number of psychoactive chemical compounds, the cannabinoids, which possess a significant pharmaceutical potential. Recently, the usage of Cannabis for medicinal purposes was legalized in many countries. Thus, the study on the influence of different cannabinoids in combination with other Cannabis -derived compounds with respect to the treatment of various diseases becomes increasingly important. Besides the production of distinct cannabinoids in a heterologous host, like tobacco or yeast, transgenic Cannabis plants would be a suitable alternative to modify and therefore optimize the cannabinoid profile. This perspective highlights the current efforts on Cannabis cell culture systems, in vitro propagation, and transformation of the plant and reveals the resulting opportunities concerning biotechnological production of cannabinoids. Furthermore, alternative platform organisms for the heterologous production of cannabinoids, like tobacco, are considered and evaluated. Georg Thieme Verlag KG Stuttgart · New York.
Kramer, P. A.; Buehler, R. D.
With increasing transport requirements, reusable space transporters again receive serious consideration in Europe as successors to the Ariane family. The paper deals with a hydrogen-ramjet-propelled, 1-1/2-stage reusable ballistic space transporter with vertical take-off and landing and using liquid hydrogen/oxygen rockets. This novel concept was developed in a theoretical study at the University of Stuttgart. The results are compared with recently published studies of several other European space transporter concepts. The data derived for the Istra - concept are: 15.4 Mg payload into low Earth-orbit, 155 Mg gross lift-off mass, 10% payload ratio, which represents a 57% propellant saving, and 44% reduction in dry mass (structure and engines) compared with comparable two-stage pure rocket concepts.
Gumz, A; Brähler, E; Heilmann, V K; Erices, R
In the context of the public debate on psychological strain among students, the prevalence of burnout, procrastination, test anxiety, other work disruptions, interpersonal problems and psychic symptoms were analyzed depending on academic degree. The data of 358 college students (of Leipzig University) were examined. The academic degree had only a marginal effect on burnout- and work disruptions-related variables. In terms of interpersonal problems and psychic symptoms, differences between students were identified, depending on the academic degree. Diploma students reported many complaints, whereas undergraduates aspiring for a State Examination, were comparatively less affected. Knowledge of the population-specific psychological load is useful in order to develop preventive and therapeutic measures. © Georg Thieme Verlag KG Stuttgart · New York.
Höfle, Mariana Carreiro da Costa Faria e Melo; Kieser, Luciana Degano
The study explores the perspectives of Mental Health Care Professionals on the importance of Sexual Health promotion of severe mentally ill people in Mental Health Care. A qualitative approach was used. Eight semi-structured Problem Centred Interviews were conducted in August 2012 in two residential facilities in Berlin. Participants are aware of the importance of Sexual Health in the psychosocial rehabilitation process. However, they believe Sexual Health Promotion is yet to be acknowledged as a legitimate Mental Health care issue. Sexual Health Promotion is poorly integrated in Mental Health Care practice. However, sexuality contributes strongly to the health and quality of life of users. Adequate guidelines on Sexual Health Promotion are not available and are urgently needed. © Georg Thieme Verlag KG Stuttgart · New York.
Andújar, Isabel; Ríos, José Luis; Giner, Rosa María; Recio, María Carmen
The naphthoquinone shikonin is the main active principle of Zicao, a traditional Chinese herbal medicine made from the dried root of Lithospermum erythrorhizon. Studies carried out over the past 30 years have provided a scientific basis for the use of Zicao which has been long employed in folk medicine to treat a variety of inflammatory and infectious diseases. In particular, shikonin has been shown to possess many diverse properties, including antioxidant, anti-inflammatory, antithrombotic, antimicrobial, and wound healing effects. The fact that shikonin shows so many beneficial properties has increased the interest in this molecule dramatically, especially in the past few years. The aim of this review is to provide an update of the new data published on shikonin, whose wide spectrum of pharmacological effects as well as pharmacokinetic properties and toxicity make it a highly interesting target molecule. Georg Thieme Verlag KG Stuttgart · New York.
Schöffner, M; Schmidt, K W; Benzenhöfer, U; Sahm, S
Since September 2009 the handling of living wills has been regulated by law. Even though a medical consultation is not imperative for the drawing up of a living will, first surveys have shown that medical information about clinical pictures and treatment options lead to an important specification of living wills. For the first time in Germany, a questionnaire has been developed to investigate the impact of medical consultations on the content of living wills. It revealed that nearly all the people surveyed who had already drawn up a living will wished to change the content of their completed will after attending the seminar because the previous version was no longer in accordance with their wishes. In the light of the frequent difficulties in hospitals concerning how to apply a living will to an actual clinical situation, we believe structured medical consultations to be indispensable. © Georg Thieme Verlag KG Stuttgart · New York.
Woronuk, Grant; Demissie, Zerihun; Rheault, Mark; Mahmoud, Soheil
Lavenders and their essential oils have been used in alternative medicine for several centuries. The volatile compounds that comprise lavender essential oils, including linalool and linalyl acetate, have demonstrative therapeutic properties, and the relative abundance of these metabolites is greatly influenced by the genetics and environment of the developing plants. With the rapid progress of molecular biology and the genomic sciences, our understanding of essential oil biosynthesis has greatly improved over the past few decades. At the same time, there is a recent surge of interest in the use of natural remedies, including lavender essential oils, in alternative medicine and aromatherapy. This article provides a review of recent developments related to the biosynthesis and medicinal properties of lavender essential oils. © Georg Thieme Verlag KG Stuttgart · New York.
Bermejo, Isaac; Nicolaus, Leonhard; Kriston, Levente; Hölzel, Lars; Härter, Martin
To ensure an adequate health care of migrants, differentiated information on the association of cultural background and migration related factors and psychosomatic complaints are necessary. Cross-sectional questionnaire based survey regarding psychosomatic complaints of migrants from Turkey (n = 77), Italy (n = 95), and Spain (n = 67) and ethnic German resettled from the states of the former Soviet Union (n = 196). Questionnaires distributed by non-health specific counselling agencies of welfare associations. The cultural background was a relevant factor for psychosomatic complaints, showing higher complaints in Turkish and ethnic German resettled migrants, also compared to a sample of age corresponding Germans. In contrast, Spanish and Italian migrants showed a lower risk for psychosomatic complaints. Also gender, feeling unwell in Germany and fatalism showed a significant association with psychosomatic complaints. Migrants in Germany do not have per se a higher risk for psychosomatic complaints. A distinct differentiation by cultural background is necessary. © Georg Thieme Verlag KG Stuttgart · New York.
Nesterko, Yuriy; Kaiser, Marie; Glaesmer, Heide
High levels of mental disorders, especially PTSD, are commonly known among groups of people forced to leave their homeland as a consequence of war-related experiences (e. g. armed conflict, torture or persecution). Depending on the cultural background the perceptions of illnesses vary, different symptom presentation and thereupon different coping strategies respectively expectations towards health care services exist. To minimize the danger of misdiagnosis by different experts working with refugees in the host countries, a culture-sensitive diagnostic approach is needed from the beginning. This article describes important aspects of culture-sensitive diagnostics by means of 2 commented case reports. Special focus is set on the aspect of linguistic and in a broader sense cultural comprehension between therapist, client and if necessary language mediator. © Georg Thieme Verlag KG Stuttgart · New York.
Kik, Charles; van Valen, Richard; Mokhles, Mostafa M; Bekkers, Jos A; Bogers, Ad J J C
Minimally invasive video-assisted epicardial beating heart ablation for lone atrial fibrillation claims to be safe and effective. We, however, report on three patients with an atrioesophageal fistula after this procedure. The exact pathogenesis of this complication is unknown. All patients presented around 6 weeks after surgery with either fever or neurological deficits. Diagnosis can be made by computed tomography scan. We advocate an aggressive surgical approach with closure of the atrial defect on cardiopulmonary bypass and closure and reinforcement of the esophagus with an intercostal muscle flap in a single-stage surgery. Some caution as to the low-risk character of this procedure seems to be realistic. Georg Thieme Verlag KG Stuttgart · New York.
Caruso, Riccardo; Artico, Marco; Colonnese, Claudio; Marrocco, Luigi; Wierzbicki, Venceslao
Supratentorial endodermal cysts are very rare pathological entities. Their pathoembryology is largely unknown and they can represent a diagnostic challenge. A research performed on the PubMed database in December 2010, to screen for supratentorial endodermal cyst studies, demonstrated that since 1960 only 31 supratentorial endodermal cysts have been described in the literature, including our case: a 42-year-old woman with a parasellar endodermal cyst. These lesions are usually benign. As with other types of brain cysts, the signs and symptoms caused by supratentorial endodermal cysts are mainly linked to the compression or irritation of surrounding neural structures. Upon neuroimaging examination, they typically appear as a round or lobulated mass. The signal intensity may vary depending on the protein content of the cyst. The majority of reported supratentorial endodermal cysts were completely excised with good or excellent results. Incomplete excision can result in an increased risk of recurrence, infection, and dissemination. Georg Thieme Verlag KG Stuttgart · New York.
Patil, Jaiprakash R; Jayaprakasha, Guddadarangavvanahally K; Kim, Jinhee; Murthy, Kotamballi N Chidambara; Chetti, Mahadev B; Nam, Sang-Yong; Patil, Bhimanagouda S
For the first time, three coumarins were isolated from the hexane extract of limes (Citrus aurantifolia) and purified by flash chromatography. The structures were identified by NMR (1D, 2D) and mass spectral analyses as 5-geranyloxy-7-methoxycoumarin, limettin, and isopimpinellin. These compounds inhibited human colon cancer (SW-480) cell proliferation, with 5-geranyloxy-7-methoxycoumarin showing the highest inhibition activity (67 %) at 25 µM. Suppression of SW480 cell proliferation by 5-geranyloxy-7-methoxycoumarin was associated with induction of apoptosis, as evidenced by annexin V staining and DNA fragmentation. In addition, 5-geranyloxy-7-methoxycoumarin arrested cells at the G0/G1 phase, and induction of apoptosis was demonstrated through the activation of tumour suppressor gene p53, caspase8/3, regulation of Bcl2, and inhibition of p38 MAPK phosphorylation. These findings suggest that 5-geranyloxy-7-methoxycoumarin has potential as a cancer preventive agent. Georg Thieme Verlag KG Stuttgart · New York.
Burkhardt, R; Pankow, W
In general chronic obstructive pulmonary disease (COPD) can be diagnosed in family practice from history and spirometry. Inconclusive spirometry findings have to be assessed further by techniques available in a pulmonologist's office. Further testing is done for differential diagnostic reasons and for prognostic appraisal. Successful smoking cessation importantly alters the natural downhill course of the disease. Patient education and rehabilitative interventions (e. g. participation in lung sport groups) help to improve life quality. Medical therapies with bronchospasmolytics applied by inhalation as monotherapies, free and fixed combinations have symptomatic benefit. Considering the increase of pneumonia risk from inhaled corticosteroids their use should be restricted to patients with a straightforward indication, e. g. coexisting asthma. © Georg Thieme Verlag KG Stuttgart · New York.
Kirchen-Peters, Sabine; Fehrenbach, Rosa-Adelinde; Diefenbacher, Albert
Many patients benefit from interventions performed by the psychiatric liaison service. Prospective longitudinal study of community dwelling elderly patients supplemented by a questionnaire answered by family members, as well as expert interviews with the members of the consultation-liaison team and semi-structured interviews with family members. The majority of patients had some benefit from the liaison psychiatric interventions, access to care was improved and lack of specialist support was reduced. In addition there was some cost offset due to prevention of admissions to nursing homes and inpatient hospital treatment. With regard to demographic developments gerontopsychiatric liaison services should be integrated into the present system of health care. This should be supported by adjusting judicial obstacles that hamper such strategies. © Georg Thieme Verlag KG Stuttgart · New York.
Müller, O; Jahn, A; Razum, O
The World Health Organisation initiated the Global Polio Eradication Initiative in the year 1988. With the large-scale application of routine and mass vaccinations in children under the age of 5 years, polio disease has become restricted to only 3 endemic countries (Afghanistan, Pakistan and Nigeria) by today. However, since the beginning of the 21st century, increasing numbers of secondary polio epidemics have been observed which were triggered through migration, political turmoil and weak health systems. In addition, there emerged serious technical (e. g., back-mutations of oral vaccine virus to wild virus) and socio-political (refusal of vaccinations in Muslim populations of Nigeria and Pakistan) problems with the vaccination in the remaining endemic countries. It thus appears questionable if the current eradiation initiative will reach its goal in the foreseeable future. © Georg Thieme Verlag KG Stuttgart · New York.
Brönner, Monika; Betz, Christine; Christ, Sarah; Froböse, Teresa; Pitschel-Walz, Gabi; Bäuml, Josef
Weight gain and metabolic disturbances are growing side effects of a modern antipsychotic therapy. Different programs were developed to reduce them. This article gives an overview of existing and evaluated programs. A literature research was made through PubMed. Relevant reviews and intervention studies were identified. Studies with the main outcome variable of weight reductions are numerous, even randomised controlled trials. Short-term weight loss under antipsychotic treatment is possible, but there is still a lack of long-term studies. Life style interventions, which include e. g. physical exercise, are not that common. Also, interventions such as wellness-activities, which contribute by means of adequate motivation strategies to an enhancement of the general well-being, are still missing. Present results turned out to be positive. Further programs which exceed weight management are required. There is necessity for more studies with consistent outcome variables and methods, especially long-term programs. Georg Thieme Verlag KG Stuttgart, New York.
Leppert, Florian; Gerlach, Jan; Ostwald, Dennis A; Greiner, Wolfgang
There are high expectations from digitalization of health care, ehealth and telemedicine. Nevertheless, the diffusion of these services falls short of expectations. This study analyses the strength and weaknesses of the German digital health economy. Thereby, we specially focus on small and medium-sized enterprises (SME). The study is based on a literature review, interviews of experts and a workshop. The digital health economy is influenced by a heterogeneous environment with both promotive and obstructive factors. One of the largest weaknesses results from a lack of business models. There is a lack of possibilities of reimbursement by the Statutory Health Insurance (SHI). In addition, private users only have a small willingness to pay for digital services. The large number of regulations makes the implementation even harder, especially for SMEs. Thus, the current environment hampers fast diffusion of digital services in the German health care market. © Georg Thieme Verlag KG Stuttgart · New York.
Cerwenka, Susanne; Nieder, Timo Ole; Richter-Appelt, Hertha
Diverse partner relationship constellations of gender dysphoric women and men with different sexual orientations are explored in a sample of 93 persons before gender-confirming interventions in persons with female gender identity and male body characteristics (MF) and persons with male gender identity and female body characteristics (FM). While in both gender groups the majority is single, relationship patterns show differences. Apart from working life, FM already live predominantly in the new, male gender role and have partners by whom they are desired as males. In contrast, only a small proportion of MF already conduct their private lives in the new, female gender role, and they often have relationships with partners sexually attracted to males and not to their female gender identity. The findings indicate a need for differing resources for gender dysphoric women and men in the process of a transsexual course of development. © Georg Thieme Verlag KG Stuttgart · New York.
Elnaggar, Mohamed Nabil; Jbeili, Kahtan; Nik-Hussin, Nik; Kozhippally, Mohandas; Pappachan, Joseph M
Amiodarone is one of the most commonly prescribed antiarrhythmic agents in clinical practice owing to its efficacy, even with high toxicity profile. The high iodine content and the prolonged biological half-life of the drug can result in thyroid dysfunction in a high proportion of patients treated with amiodarone even after cessation of amiodarone. Both hypothyroidism and hyperthyroidism are common side effects that mandate regular monitoring of patients with thyroid function tests. Amiodarone-induced hypothyroidism (AIH) is diagnosed and managed in the same way as a usual case of hypothyroidism. However, differential diagnosis and clinical management of amiodarone-induced thyrotoxicosis (AIT) subtypes can be challenging. With the aid of a case snippet, we update the current evidence for the diagnostic work up and management of patients with amiodarone-induced thyroid dysfunction in this article. © Georg Thieme Verlag KG Stuttgart · New York.
Nyberg, E; Stieglitz, R-D; Flury, M; Riecher-Rössler, A
BACKGROUND AND HYPOTHESES: Domestic violence is common and can lead to severe physical and psychological problems. Thus, we have investigated the frequency of occurrence, forms and risk factors of domestic violence against female patients on a crisis intervention ward. 115 women were screened with the "screening spouse violence" (SPG) and the "index of spouse abuse" (ISA). The life time prevalence concerning spouse violence was 70 %. Out of 74 women who were currently living in a relationship 28 (38 % )were victims of violence in the last 12 months prior to their admission. Women who experienced violence had a significantly lower level of education. Screening for domestic violence in female patients in the field of crisis intervention and psychiatry should become a standard of "good clinical practice". © Georg Thieme Verlag KG Stuttgart · New York.
Steinert, Tilman; Heinz, Andreas; Hohl-Radke, Felix; Koller, Manfred; Müller, Jürgen; Müller, Sabine; Zinkler, Martin
The term of a "considerable damage to one's health" is central in German guardianship law with respect to judge's decisions on involuntary commitment and coercive treatment. A legal definition has not been provided, and up to now no explanations from the part of medicine have been available what a "considerable damage to one's health" is in the case of mental illness and how it can be determined. A consensus paper of the German Association of Psychiatry and Psychotherapy (DGPPN) explains four possible scenarios of manifestation of such kind of damage, corresponding to somatic illnesses: evidence of structural brain lesions (rare), subjective suffering (sufficient, but not necessary), impairment of functioning in important areas of life, and severe impairment of social participation (e. g. by dangerous behaviour against others). This view corresponds with the WHO's bio-psycho-social concept of health. © Georg Thieme Verlag KG Stuttgart · New York.
Sperth, Michael; Hofmann, Frank-Hagen; Holm-Hadulla, Rainer Mathias
In this first effectiveness study of psychotherapeutic counseling for students in German-speaking countries, the effectiveness of an integrative model of counseling was evaluated based on a sample of 151 clients. Effectiveness of integrative counseling according to the ABCDE-model was found to be high in comparison to other international studies in this area. Pre-post differences on measures of mental distress and satisfaction were significant and effect sizes were mostly moderate to high. A high percentage of clients improved statistically and clinically significant. Counselors' expert rating and diagnostics according to ICD-10 that have been included in contrast to previous effectiveness studies showed that clients suitable for the counseling setting get treated in the counseling center while more severely disturbed clients in terms of psychopathology or diagnosis get referred to outpatient treatment, drop out or object to provide post-data. © Georg Thieme Verlag KG Stuttgart · New York.
Walther, Anna Lena; Schreiber, Dora; Falk, Johannes; Deck, Ruth
Aim The aim of the study was to identify the subjective level of information and information needs of patients with an approved rehabilitation application and patients at the end of rehabilitation with regard to preferred subjects and kind of information transfer. Method Written survey with N=283 patients with approved rehabilitation application and N=388 patients at the end of rehabilitation. Results Both groups reported high information needs particularly regarding treatments during rehabilitation, rehabilitation aftercare and rehabilitation aims. A conversation with their physician, a brochure and a website are the preferred information pathways. Conclusion Taking into account the topics for which both groups require information and the preference regarding the kind of information transfer can make a valuable contribution for the development of needs-oriented information material. © Georg Thieme Verlag KG Stuttgart · New York.
Piantanida, E; Lai, A; Sassi, L; Gallo, D; Spreafico, E; Tanda, M L; Bartalena, L
Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas and is ultimately due to antibodies interacting with the TSH receptor on thyroid follicular cells [TSH-receptor antibody (TRAb)]. Antithyroid drugs (ATDs) belonging to the family of thionamides are the first-line treatment in Europe. ATD treatment is commonly continued for 18-24 months. Its major limitation is the high rate of relapses after drug withdrawal. Factors particularly bound to subsequent relapses are the large thyroid volume, smoking habit, persistence of TRAb in the circulation at the end of treatment, and the post-partum period. Under these conditions, consideration should be given to a definitive therapy for hyperthyroidism (radioiodine treatment, thyroidectomy), particularly if the patient is at risk of cardiovascular complications that might be exacerbated by persistence or recurrence of hyperthyroidism. © Georg Thieme Verlag KG Stuttgart · New York.
Ventosa, A; Ramos-Cormenzana, A; Kocur, M
38 strains of moderately halophilic Gram-positive, catalase-positive cocci were isolated from saline soils and the ponds of a solar saltern in Alicante (Spain). They were divided into three biochemically distinct groups. On the basis of the characteristics investigated the 25 strains of group I corresponded to Planococcus halophilus; the ten strains of group II were morphologically and biochemically similar to the species Sporosarcina halophila; group III, comprising three strains, differed strikingly from the previous groups in certain biochemical tests. These strains differed from the planococci and micrococci so far described and were tentatively designated as Planococcus sp. The results have shown that moderately halophilic Gram-positive, motile cocci, are frequent inhabitants of hypersaline environments. Copyright Â© 1983 Gustav Fischer Verlag, Stuttgart/New York. Published by Elsevier GmbH.. All rights reserved.
Vongsak, Boonyadist; Mangmool, Supachoke; Gritsanapan, Wandee
The leaves of Moringa oleifera, collected in different provinces in Thailand, were determined for the contents of total phenolics, total flavonoids, major components, and antioxidant activity. The extract and its major active components were investigated for the inhibition of H2O2-induced reactive oxygen species production and the effects on antioxidant enzymes mRNA expression. The extract, crypto-chlorogenic acid, isoquercetin and astragalin, significantly reduced the reactive oxygen species production inducing by H2O2 in HEK-293 cells. Treatment with isoquercetin significantly increased the mRNA expression levels of antioxidant enzymes such as superoxide dismutase, catalase and heme oxygenase 1. These results confirm that M. oleifera leaves are good sources of natural antioxidant with isoquercetin as an active compound. Georg Thieme Verlag KG Stuttgart · New York.
Huang, Pei-Ming; Chou, Nai-Kuan; Lin, Tzu-Hsin; Chen, Chiung-Nien
Massive malignant hemothorax (MMH) is a rare and serious complication encountered in the field of oncology and can be life threatening. It is often difficult and complex to manage. Herein, we present cases of four patients who had MMH and in whom a hemothorax was successfully stopped via continuous intrapleural irrigation with epinephrine (5-mg epinephrine/1,000-mL normal saline, infused at 100 mL/h) instead of a conventional surgical approach. Although no patient deaths were attributed to intractable bleeding, two deaths were related to multiple organ failure. Despite the limited number of cases, this method was a convenient, effective, and inexpensive alternative to open surgical or thoracoscopic drainage for MMH. Georg Thieme Verlag KG Stuttgart · New York.
Fumarola, A; Di Fiore, A; Dainelli, M; Grani, G; Calvanese, A
Methimazole (MMI) and propylthiouracil (PTU) are the main antithyroid drugs used for hyperthyroidism. They inhibit the synthesis of thyroid hormone at various levels and are used as the primary treatment for hyperthyroidism or as a preparation before radioiodine therapy or thyroidectomy. MMI is the drug of choice because of its widespread availability, longer half-life and small number of severe side effects. Drugs of second choice are potassium perchlorate, beta blockers, iodine, lithium carbonate and glucocorticoids. Rituximab, a monoclonal antibody directed against human CD20, was recently proposed as a biological therapy for cases of Graves' disease unresponsive to traditional drugs. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.
von Peter, Sebastian; Schwedler, Hans-Jochen; Amering, Michaela; Munk, Ingrid
The aim is to explore the multivariant effects of trialogue groups from the perspectives of the participants. We combined a questionnaire with focus-groups. Communication in trialogue groups is clearly different from clinical encounters. All three groups cherish and apsire to interest for each other, good will and openness. Daily clinical routine with role prescriptions, power balance and constant pressure to act is experienced as an obstacle. Users and ex-users describe the healing effect of creating a narrative in a public environment. Trialog facilitates a discrete and independent form of communication and acquisition and production of knowledge. Trialogue groups seem to be experimental grounds, teaching participants how to develop equal relationships. Their open atmosphere might be caused by less mutual responsibilities or pressure to act. Trialogue groups have the potential to become even more public. © Georg Thieme Verlag KG Stuttgart · New York.
Scholbrock, A. K.; Fleming, P. A.; Fingersh, L. J.
Wind turbines are complex, nonlinear, dynamic systems driven by aerodynamic, gravitational, centrifugal, and gyroscopic forces. The aerodynamics of wind turbines are nonlinear, unsteady, and complex. Turbine rotors are subjected to a chaotic three-dimensional (3-D) turbulent wind inflow field with imbedded coherent vortices that drive fatigue loads and reduce lifetime. In order to reduce cost of energy, future large multimegawatt turbines must be designed with lighter weight structures, using active controls to mitigate fatigue loads, maximize energy capture, and add active damping to maintain stability for these dynamically active structures operating in a complex environment. Researchers at the National Renewable Energymore » Laboratory (NREL) and University of Stuttgart are designing, implementing, and testing advanced feed-back and feed-forward controls in order to reduce the cost of energy for wind turbines.« less
Kühl, J S; Schwarz, K; Münch, A; Schmugge, M; Pekrun, A; Meisel, C; Wahn, V; Ebell, W; von Bernuth, H
Adenosin deaminase (ADA) deficiency is the cause for Severe Combined Immunodeficiency (SCID) in about 15% of patients with SCID, often presenting as T (-)B (-)NK (-)SCID. Treatment options for ADA-SCID are enzyme replacement, bone marrow transplantation or gene therapy. We here describe the first patient with ADA-SCID and fatal hepatic failure despite bone marrow transplantation from a 10/10 HLA identical related donor. As patients with ADA-SCID may be at yet underestimated increased risk for rapid hepatic failure we speculate whether hepatitis in ADA-SCID should lead to the immediate treatment with enzyme replacement by pegylated ADA. © Georg Thieme Verlag KG Stuttgart · New York.
Laubner, Katharina; Seufert, Jochen
Type 2- diabetes mellitus (T2DM) represents a major risk factor for cardiovascular complications and mortality. Strict glucose control in the early course of the disease prevents cardiovascular complications only in the long run. Non-medical therapies (diet, exercise, body weight reduction) bear little evidence for positive cardiovascular effects.Bariatric surgery is not number one choice in therapy of T2DM. Metformin seems to provide positive cardiovascular effects. Insulin seems to be cardiovascular neutral, as well as the DPP4-inhibitors Saxagliptin, Sitagliptin and Alogliptin. Concerning GLP-1-RAs, Lixisenatide has a neutral cardiovascular effect, whereas Liraglutide and Semaglutide reduce cardiovascular outcomes. The SGLT2-inhibitor Empagliflozin reduces cardiovascular mortality, total mortality and hospitalization by heart failure. © Georg Thieme Verlag KG Stuttgart · New York.
Neuhann, T M
If not due to trauma, ectopia lentis is usually caused genetically. It is a main symptom of several syndromal disorders such as Marfan syndrome or homocystinuria. Also other connective tissue disorders convey an elevated risk for ectopia lentis. Isolated ectopia lentis is frequently caused by genetic alterations as well, most commonly due to mutations in ADAMTSL4. Depending on the molecular basis, the consequences for the management of patients may differ significantly: On the one hand, possible accompanying symptoms may require a specific surveillance and treatment. Also, the risk for other family members to develop ectopia lentis or accompanying symptoms can only be determined if the genetic cause and thus inheritance pattern are known. This review describes the different types and genetic causes of syndromal and isolated ectopia lentis as well as possible consequences for the patients; also it presents a sensible algorithm for the molecular diagnostic approach. Georg Thieme Verlag KG Stuttgart · New York.
Stenzel, Werner; Schoser, Benedikt
Inherited and acquired muscular weakness is caused by multiple conditions. While the inherited ones are mostly caused by mutations in genes coding for myopathic or neurogenic diseases, the acquired ones occur due to inflammatory, endocrine, or toxic etiologies. Precise diagnosis of a specific disease may be challenging and may require a multidisciplinary approach. What is the current place for a diagnostic biopsy of skeletal muscle? Diagnostic muscle biopsy lost in this context its first-tier place in the primary diagnostic workup for some diseases, but it is still mandatory for others. We here summarize conditions in which we believe a diagnostic sample is most relevant and mention those in which a biopsy may be secondary or can even be left out. We would like to stress that muscle biopsy nowadays has a new important place in description and definition of new diseases, for example, discovered by modern genetic approaches. Georg Thieme Verlag KG Stuttgart, New York.
Calliess, Tilman; Savov, Peter; Ettinger, Max; Karkosch, Roman
Today, there is an almost endless variety of knee prosthesis models on the market from which the surgeon can choose. Although the designs appear closer and closer to one another, the industry makes a great effort to emphasise different features as beneficial and a stand-alone. It is increasingly difficult to keep an overview and to assess the clinical relevance of the diverse features. There is a clear lack of independent comparative studies and evidence is low. Nevertheless, different design philosophies require special surgical techniques, so that the surgeon must be familiar with the peculiarity of his/her prosthesis. Also, a differentiated indication for different designs appears to be an interesting concept. The aim of this essay is to give a brief overview of the major design concepts of current unconstrained knee prosthesis designs and their differences regarding biomechanics and kinematics. Georg Thieme Verlag KG Stuttgart · New York.
Munding, J; Ziebarth, W; Belyaev, O; Uhl, W; Tannapfel, A
The surveillance of patients with Barrett mucosa in the distal oesophagus leads to an increase of patients diagnosed with early cancer of the oesophagogastric junction and stomach with only superficial infiltration. Comparable to Asian countries where screening of patients at risk is recommended due to the high incidence of gastric cancer, endoscopic resection of early cancer in the stomach and distal oesophagus is increasing. In spite of the special endoscopic techniques--there are several requirements for the resected specimen which ensure its exact pathohistological evaluation. This is necessary to detect the exact depth of infiltration and the resection margins. To provide an exact pathohistological diagnosis is important for further therapeutic implications and prognosis. Advanced carcinomas of the oesophagus and stomach need multimodal treatment with radiation and chemotherapy. This has a special impact on the tumour which leads to pathohistological detectable changes as estimated in the so-called regression grading. Georg Thieme Verlag KG Stuttgart · New York.
Tsukamoto, Sachiko; Yokosawa, Hideyoshi
The ubiquitin-proteasome system plays a critical role in selective protein degradation and regulates almost all cellular events such as cell cycle progression, signal transduction, cell death, immune responses, metabolism, protein quality control, development, and neuronal function. The recent approval of bortezomib, a synthetic proteasome inhibitor, for the treatment of relapsed multiple myeloma has opened the way to the discovery of drugs targeting the proteasome and ubiquitinating and deubiquitinating enzymes as well as the delivery system. To date, various synthetic and natural products have been reported to inhibit the components of the ubiquitin-proteasome system. Here, we review natural products targeting the ubiquitin-proteasome system as well as synthetic compounds with potent inhibitory effects. Georg Thieme Verlag KG Stuttgart-New York.
Rottmann, M; Mielck, A
'Walkability' is mainly assessed by the NEWS questionnaire (Neighbourhood Environment Walkability Scale); in Germany this questionnaire is widely unknown. We now try to fill this gap by providing a systematic overview of empirical studies based on the NEWS. A systematic review was conducted concerning original papers including empirical analyses based on the NEWS. The results are summarised and presented in tables. Altogether 31 publications could be identified. Most of them focus on associations with the variable 'physical activity', and they often report significant associations with at least some of the scales included in the NEWS. Due to methodological differences between the studies it is difficult to compare the results. The concept of 'walkability' should also be established in the German public health discussion. A number of methodological challenges remain to be solved, such as the identification of those scales and items in the NEWS that show the strongest associations with individual health behaviours. © Georg Thieme Verlag KG Stuttgart · New York.
Hebebrand, J; Hamelmann, E; Hartmann, A; Holtmann, M; Jöckel, K-H; Kremer, U; Legenbauer, T; Lücke, T; Radkowski, K; Reinehr, T; Wand, K; Mühlig, Y; Föcker, M
Objectives: In this selective review we provide an overview of the current pre- and postnatal screenings up to 18 years established in Germany to inform physicians of different medical fields (gynecologists, pediatricians, general practitioners, other medical specialists who treat children, adolescents or pregnant females). Current State: Research on screening for different types of cancer has frequently failed to show any benefit. Thus, there is a need to broaden the evidence basis related to medical screenings especially for children and adolescents. Outlook: Potential future developments of pre- and postnatal screenings are illustrated including their social impact. The lack of an early detection of mental health problems is pointed out. An interdisciplinary collaboration and research is required to accumulate evidence with regard to medical screenings and to consider health economic and ethical aspects. © Georg Thieme Verlag KG Stuttgart · New York.
Voermans, N C; Dijk, K G J van; Bos, M M; Geus-Oei, L-F de; Verrips, A; Lindert, E J van
We here report a 13-year-old Marfan patient who suffered from severe, medication-resistant, intermittent headache, which was provoked when getting into an upright position and immediately relieved by lying down or after intravenous rehydration. The postural benefit and the sudden relief after intravenous hydration suggested (intermittent) intracranial hypotension, although a normal opening pressure on lumbar punction was observed and no cerebrospinal fluid (CSF) leakage was identified. Imaging studies revealed severe dural ectasia at lumbosacral level, and two intradural cysts and two extradural presacral cysts were detected. Most likely, altered hydrodynamics in intra- and extracranial spinal meningeal cysts caused intermittent CSF hypotension above these cysts, resulting in intermittent intracranial hypotension. Surgical marsupialisation of the intradural cysts proved to be effective. This resulted in a significant reduction of the headache during the clinical follow-up of eight years. Georg Thieme Verlag KG Stuttgart New York.
Dudeck, Manuela; Drenkhahn, Kirstin; Spitzer, Carsten; Barnow, Sven; Freyberger, Harald Jürgen; Grabe, Hans Jörgen
12-35% of all sexual delinquents report victimization through early sexual abuse. To date, studies are based on small samples and mostly come from English-language countries. As part of an interdisciplinary study on the human rights situation in long-term imprisonment, we examined 1,055 prisoners from 11 countries in Europe with the posttraumatic stress diagnostic scale (PDS) concerning their traumas in relation to their offences. Sexual delinquents who reported own prior sexual abuse within the family had a fourfold increase in committing sexual offences later in their life compared to other offenders. A detailed trauma history which includes sexual offences within the family is essential for adequate therapy and relapse prevention. © Georg Thieme Verlag KG Stuttgart · New York.
Kortmann, Lisa-Maria; Müller, Dirk; Simic, Dusan; Civello, Daniele; Stock, Stephanie
Objective Quantification of the economic burden for society and the German Statutory Pension Insurance due to early retirement in schizophrenia. Methods Based on empirical data of the German Statutory Pension Insurance, productivity losses were calculated using the human capital approach. Results The total expenditures of the German Statutory Pension Insurance due to pension payments for schizophrenic insurants amounted to € 450 million. Total indirect costs due to morbidity and mortality were estimated at € 2,3 million. Average indirect costs per patient ranged between € 17 000 - 28 000, depending on rates for discounting and inflation. Conclusion Regarding substantial economic consequences, preventive measures and therapeutic procedures should aim to prevent reduction in earning capacity and to promote occupational reintegration of schizophrenic patients. © Georg Thieme Verlag KG Stuttgart · New York.
Lichy, Gregor; Braun, Jörg
Due to the increasingly changed clinical landscape, which leads to a reduction of clinical facilities in rural regions. This also leads to a centralized clinical care, in addition to limited care options in the periphery. Therefore the interhospital transfer is becoming increasingly important. Specialized centers have become more and more important through this centralization of clinical care. Not only the number of transports, but also the transport distances have steadily increased in recent years. It is necessary to differentiate centripetal transports into the centers of the maximum and centrifugal transports back to peripheral clinics, weaning devices or rehabilitation facilities. Especially in the case of the latter, the number of patients still to be transported under intensive medical conditions has clearly increased. © Georg Thieme Verlag Stuttgart · New York.
Dame, David A; Meisch, Max V; Lewis, Carolyn N; Kline, Daniel L; Clark, Gary G
Four commercially available spatial repellent devices were tested in a rice-land habitat near Stuttgart, AR, after semi-field level assessments had been made at the Center for Medical, Agricultural, and Veterinary Entomology, Agricultural Research Service, US Department of Agriculture in Gainesville, FL. OFF! Clip-On(metofluthrin), Mosquito Cognito (linalool), No-Pest Strip (dichlorvos), and ThermaCELL (d-cisltrans allethrin) were selected for this study from >20 candidate products. The units based on metofluthrin, linalool, or d-cisltrans allethrin significantly reduced captures of 1 or more of the mosquito species at surrogate human sites (unlit Centers for Disease Control and Prevention traps with CO2 and octenol). Among the mosquito species analyzed statistically (Anopheles quadrimaculatus, Culex erraticus, and Psorophora columbiae), there were significantly different responses (up to 84% reduction) to individual products, suggesting that combinations of certain spatial repellents might provide significantly greater protection.
Lee, Kyung Yeon; Yeh, Hye-Ryun
Brain stem encephalitis is a cardinal presentation of central nervous system involvement in enterovirus 71 infection, and manifests as myoclonus, ataxia, tremor, and autonomic dysfunction. A 2-month-old infant with enterovirus 71 brain stem encephalitis demonstrated continuous myocloni and tonic spasms. On admission, the patient's myoclonus, which mainly involved the shoulders and the arms, was considerably worse during wakefulness and occurred once or twice a minute. Several hours after admission, the myoclonic jerks steadily worsened, appeared ceaselessly every 1 to 2 seconds, and were intermixed with tonic spasms of all four extremities accompanied by crying. Video electroencephalography revealed a normal background without epileptiform discharges and no ictal electroencephalographic changes during the myoclonic jerks and tonic spasms. Complete remission was achieved without complications after completion of a 3-day immunoglobulin therapy. This case suggests that the brain stem may be a major origin site for not only myoclonus but also tonic spasm. Georg Thieme Verlag KG Stuttgart · New York.
Obiekezie, A; Schmahl, G
The ultrastructure of the host-parasite interface was studied in Henneguya laterocapsulata, parasitizing the skin of hybrid catfishes (Clarias gariepinus × Heterobranchus bidorsalis) in Nigeria. The plasmodia were located between malpighian cells, which are the main elements of the multilayered fish epidermis, and were bordered by a single cell membrane. The desmosomal junctions between the malpighian cells were forced apart by finger-like protrusions of the Plasmodium. These plasmodial protrusions finally ran into the host cell without disrupting of the host cell membrane and formed network-like extensions. At the margin of the plasmodium an extensive vacuolization occurred, leading to a wavy surface. Infections with H. laterocapsulata may be an adverse factor in the large-scale production of hybrid catfish fingerlings used for aquaculture in Africa. Copyright © 1993 Gustav Fischer Verlag · Stuttgart · Jena · New York. Published by Elsevier GmbH.. All rights reserved.
Hippelein, M; Matthiessen, A; Kolychalow, O; Ostendorp, G
In rural areas of Schleswig-Holstein, Germany, drinking water for about 37 000 people is provided by approximately 10 000 small-scale water supplies. For those wells data on pesticides in the drinking water are rare. In this study 100 small-scale water supplies, mainly situated in areas with intensive agriculture, fruit-growing or tree-nursery, were selected and the drinking water was analysed for pesticides. In 68 samples at least one agent or metabolite was detectable, 38 samples showed multiple contaminations. The metabolites dimethylsulfamide and chloridazone-desphenyl were found in nearly 40% of the wells in concentrations up to 42 µg/L. Bentazone was the most frequently detected biocidal agent. These data show that pesticides in drinking water from small-scale supplies are a notable issue in preventive public health. © Georg Thieme Verlag KG Stuttgart · New York.
Hoefer, J; Streif, W; Kilo, J; Grimm, M; Berger, G; Velik-Salchner, C
A child was admitted to our hospital for repair of a ventricular septal defect (VSD) characterized by a predominantly right-to-left shunt and a severe stenosis of the right ventricular outflow tract (Tetralogy of Fallot). Severe congenital anemia (hemoglobin 72 g/L), thrombocytopenia (42×G/L) and profound platelet dysfunction led a stem cell defect to be suspected. X-linked thrombocytopenia (GATA-1 mutation) was diagnosed. GATA-1 defect may complicate medical interventions due to excessive bleeding and partial or complete bone marrow failure. Maintaining a platelet count of 100 G/L and a maximal clot firmness (EXTEM-MCF) >50 mm allowed repair of the congenital heart defect without bleeding or hematological complications. Anemia and thrombocytopenia persisted after cardiac surgery, while the spontaneous bleeding tendency improved. © Georg Thieme Verlag KG Stuttgart · New York.
Based upon biographical information and a summary of E.A. Dölle's contributions to psychotherapy research, this paper describes how Dölle - obviously during his time in a British war prison - had some encounters with John Bowlby, father of attachment theory, and how these encounters might have influenced Dölle during his later years. These years were spent at the Catholic University Eichstätt, where Dölle tried to positively influence the development of values and their "sensitivity for sensitivity" among Catholic students. The paper concludes that Dölle probably would be disappointed if he could see current developments within science and - even more - within society. George Thieme Verlag KG Stuttgart · New York.
Kurch, L; Mauz-Körholz, C; Bertling, S; Wallinder, M; Kaminska, M; Marwede, D; Tchavdarova, L; Georgi, T W; Elsner, A; Barthel, A; Stoevesandt, D; Hasenclever, D; Sattler, B; Sabri, O; Körholz, D; Kluge, R
Since 2007, children and adolescents with Hodgkin lymphomas are treated in the Europe-wide EuroNet-PHL trials. A real time central review process for stratification of the patients enhances quality control and efficient therapy management. This process includes reading of all cross-sectional-images. Since reference evaluation is time critical, a fast, easy to handle and safe data transfer is important. In addition, immediate and constant access to all the data has to be guaranteed in case of queries and for regulatory reasons. To meet the mentioned requirements the EuroNet Paediatric Hodgkin Data Network (funded by the European Union - Project Number: 2007108) was established between 2008 and 2011. A respective tailored data protection plan was formulated. The aim of this article is to describe the networks' mode of operation and the advantages for multi-centre trials that include centralized image review. © Georg Thieme Verlag KG Stuttgart · New York.
Jäger, Christoph; Hrenn, Andrea; Zwingmann, Jörn; Suter, Andreas; Merfort, Irmgard
Arnica preparations have long been used for the symptomatic treatment of rheumatic complaints and recent clinical trials have demonstrated the beneficial effects of Arnica preparations in the treatment of osteoarthritis (OA). The efficacy of Arnica is presumed to be mainly due to its anti-inflammatory properties and inhibition of the transcription factor NF-kappaB. Here we provide further insights into its molecular mode of action. Arnica preparations suppress MMP1 and MMP13 mRNA levels in bovine and human articular chondrocytes in a concentration-dependent manner and in a low concentration range. This suppression may be due to inhibition of DNA binding of the transcription factors AP-1 and NF-kappaB. Interestingly, sesquiterpene lactones present in the preparations were always more active than the pure compounds, demonstrating the advantage of using plant preparations. Georg Thieme Verlag KG Stuttgart, New York.
Schäfer, C N; Guldager, H; Jørgensen, H L
A 26-year-old male bodybuilder was admitted to the surgical department of a Danish community hospital for hematemesis. During the clinical interview, he revealed that he had recently finished a course of anabolic steroids and erythropoietin. The patient also had a previous history of infections and chronic ulcers due to paraffin-oil injections in both upper arms one year before. Over the course of the next few hours, the patient developed signs of multi-organ dysfunction, including pancreatitis, hemorrhagic gastritis, nephropathy with temporary anuria, and respiratory insufficiency, and was transferred to the ICU. After manometric monitoring on the patient's upper arms proved difficult, invasive blood pressure monitoring was used and revealed that the patient was in a state of hypertensive crisis. This case of multi-organ dysfunction was possibly caused by multi-substance-induced hypercalcemia. © Georg Thieme Verlag KG Stuttgart · New York.
Loehle, Stefan; Nawaz, Anuscheh; Herdrich, Georg; Fasoulas, Stefanos; Martinez, Edward; Raiche, George
This article is a companion to a paper on heat flux measurements as initiated under a Space Act Agreement in 2011. The current focus of this collaboration between the Institute of Space Systems (IRS) of the University of Stuttgart and NASA Ames Research Center is the comparison and refinement of diagnostic measurements. A first experimental campaign to test different heat flux gages in the NASA Interaction Heating Facility (IHF) and the Plasmawindkanaele (PWK) at IRS was established. This paper focuses on the results of the measurements conducted at IRS. The tested gages included a at face and hemispherical probe head, a 4" hemispherical slug calorimeter, a null-point calorimeter from Ames and a null-point calorimeter developed for this purpose at IRS. The Ames null-point calorimeter was unfortunately defective upon arrival. The measured heat fluxes agree fairly well with each other. The reason for discrepancies can be attributed to signal-to-noise levels and the probe geometry.
Ansmann, L; Kuhr, K; Kowalski, C
Multilevel Analysis (MLA) are still rarely used in Health Services Research in Germany, though hierarchical data, e. g. from patients clustered in hospitals, is often present. MLA provide the valuable opportunity to study the health care context in health care organizations and the associations between context and health care outcomes. This article's aims are to introduce this particular method of data analysis, to discuss its' benefits and its' applicability particularly for Health Services Research focusing on organizational characteristics and to provide a concise guideline for performing the analysis. First, the benefits and the necessity for MLA compared to ordinary correlation analyses in the case of hierarchical data are discussed. Furthermore, the statistical requirements and key decisions for the performance of MLA are illustrated. © Georg Thieme Verlag KG Stuttgart · New York.
Crespo, Gloria; González-Menéndez, Víctor; de la Cruz, Mercedes; Martín, Jesús; Cautain, Bastien; Sánchez, Pilar; Pérez-Victoria, Ignacio; Vicente, Francisca; Genilloud, Olga; Reyes, Fernando
During a high-throughput screening program focused on the discovery and characterization of new antifungal compounds, a total of 8320 extracts from Fundacion MEDINA's collection were screened against a panel of 6 fungal parasitic strains, namely Candida glabrata, Candida krusei, Candida parapsilosis, Candida tropicalis, Candida albicans , and Aspergillus fumigatus . A total of 127 extracts displayed antifungal properties and, after LC/MS dereplication, 10 were selected for further fractionation. Bioassay-guided fractionation from a 1-L fermentation of one of these extracts, belonging to the fungus Chaetopsina sp., led to the isolation of linoleyl sulphate ( 1 ), linolenyl sulphate ( 2 ), and oleyl sulphate ( 3 ) as the compounds responsible for the antifungal activity. These molecules were previously described as synthetic products with the ability to produce the allosteric inhibition of soybean lipoxygenase and human lipoxygenase. Georg Thieme Verlag KG Stuttgart · New York.
Roch, S; Hampel, P
Bei chronischen, nicht spezifischen Rückenschmerzen haben psychische Komorbiditäten deutlich zugenommen, sodass im Rahmen einer multimodalen Behandlung zunehmend auch psychotherapeutische Behandlungsansätze implementiert werden. Ziel dieses Reviews war es, die aktuelle Forschung zu psychologischen Aspekten bei der Behandlung von chronischen Rückenschmerzen zu thematisieren. Dazu wurde eine selektive Literaturrecherche durchgeführt, um Studien aus Deutschland zu identifizieren, die in den letzten 5 Jahren veröffentlicht wurden. Dabei wurden 12 Artikel von 5 Forschergruppen gefunden, die unterschiedliche Aspekte der stationären, teilstationären und ambulanten Rehabilitation sowie der Nachsorge thematisierten. Die Evidenz für die Effektivität von psychologischer Behandlung bei chronischen Rückenschmerzen ist in den letzten Jahren gestiegen, gerade im Bereich der Nachsorge ist jedoch weitere Forschung für eine erfolgreiche Implementierung notwendig. © Georg Thieme Verlag KG Stuttgart · New York.
Grande-Martín, Alberto; Pardal-Fernández, José Manuel; Carrascosa-Romero, María Carmen; De Cabo, Carlos
Antiepileptic drugs may occasionally increase seizure frequency or eliciting de novo seizure occurrence; the underlying mechanism of these effects is not known. The potential adverse effects of valproic acid in myoclonic astatic epilepsy have been noted by experienced clinicians in various different regions of the world, but this important observation has not been sufficiently reported. We present the case of tonic status epilepticus in an 8-year-old boy with Doose syndrome related to valproic acid. Valproic acid, such as others antiepileptic drugs, is liable to produce paradoxical effects such as the atypical seizures we report. We emphasize the importance for the management of acute seizures in an intensive care unit setting and increase awareness of the acute toxic effects of antiepileptic drugs. Georg Thieme Verlag KG Stuttgart · New York.
Rumm, R; Böcking, W
This article analyses the impact of a potential deregulation Germany's pharmacy market by allowing foreign ownership of pharmacies and removing the limit of the number pharmacies that can be owned by a pharmacist. Based on a mathematical model and empirical values of foreign countries, scenarios for the German market are calculated and the impact on all participants of the health care system analysed. The key outcomes are:- A deregulation would enables the creation of pharmacy chains- In all simulated scenarios the total number of pharmacies would drastically grow- The increased pharmacy density improves patient centred drug care- The competition among pharmacies increases and leads to the closure of many independently owned and operated pharmacies. © Georg Thieme Verlag KG Stuttgart · New York.
Allroggen, M; Rau, T; Fegert, J M
Sexual harassment among adolescents has long been neglected in Germany though it is frequent and leads to significant strain for the victims. In international studies, the prevalence of sexual harassment ranges from 10 to 80 % among students. For the development of sexual harassment individual as well as school based factors play a role. Different pathways lead to this problematic behaviour. The effect of new media in the development of sexual harassment cannot be estimated so far. Frequent consequences of sexual harassment in addition to school associated difficulties are unspecific somatic complaints. General practitioners and pediatricians are frequently consulted tn the first place. Recommendations for consultation and interventions are presented. © Georg Thieme Verlag KG Stuttgart · New York.
Hainich, J; von Rechenberg, B; Jakubietz, R G; Jakubietz, M G; Giovanoli, P; Grünert, J G
Surgical treatment of osteoporotic distal radius fractures with locking plates does not completely prevent loss of reduction. Additional bone deficit stabilisation with the use of bone substitute materials is receiving increased attention. Most knowledge on the in vivo behavior of bone substitutes originates from a small number of animal models after its implantation in young, good vascularized bone. This paper investigates the osteoconductivity, resorption and biocompatibility of beta-tricalcium phosphate as a temporary bone replacement in osteoporotic type distal radius fractures. 15 bone samples taken from the augmented area of the distal radius of elderly people during metal removal were examined. The material was found to be osteoconductive, good degradable, and biocompatible. Degrading process and remodelling to woven bone seem to require more time than in available comparative bioassays. The material is suitable for temporary replacement of lost, distal radius bone from the histological point of view. © Georg Thieme Verlag KG Stuttgart · New York.
Wormanns, D; Hamer, O W
The Fleischner Society has published several recommendations for terms for thoracic imaging. The most recent glossary was released in 2008. One glossary in German language was published in 1996. This review provides an updated German glossary of terms for thoracic imaging. It closely adheres to the Fleischner Society terminology. In some instances adaptions to the usage of German language were necessary, as well as some additions of terms which were later defined or redefined. These deviations are summarized in a revision report. The Fleischner Society has published a revised version of her glossary of terms for thoracic imaging in 2008. This paper presents a German adaption of this glossary. Some terms not contained in the original version have been added. The general use of the presented terminology in radiological reports is recommended. © Georg Thieme Verlag KG Stuttgart · New York.
Horn, Ernst-Peter; Torossian, Alexander
Inadvertent perioperative hypothermia impairs postoperative outcome in surgical patients due to ischemic myocardial events, wound infections and coagulation disorders. Body core temperature should be assessed 1-2h preoperatively and continuously during surgery. To prevent hypothermia patients and nursing clinical staff should be teached and trained. Preoperatively surgical patients should always be prewarmed by using convective warming devices and active warming should be continued in surgeries longer than 1 hour. Warming of IV fluids is effective if infusion rates are above 1l/h. Core temperature should be measured in the recovery room and active warming should be started when patients are hypothermic or if they feel cold. Georg Thieme Verlag Stuttgart * New York.
The customs and traditions associated with Christmas may result in allergic reactions to allergens that are typical for this period. On the one hand the rise in prevalence of allergic diseases has continued in the industrialized world for the last decades and allergies are regarded as widespread diseases. On the other hand the 21th century is a time of "allergy delusion". This review summarizes the facts about allergic reactions to Christmas typical decoration, food and behavior. Taken together, allergic reactions to Christmas tree, poinsettia, Christmas cactus, perfumed candles, Christmas typical food, common gifts like mobile phones and laptops, frankincense, myrrh and pollens have been described but in very rare instances. The chance to survive Christmas without allergic symptoms is high, particularly for non-atopics. © Georg Thieme Verlag KG Stuttgart · New York.